Radiology and Oncology最新文献

{"title":"[¹⁸F]fluorocholine PET <i>vs</i>. [^99mTc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency.","authors":"Sebastijan Rep, Klara Sirca, Ema Macek Lezaic, Katja Zaletel, Marko Hocevar, Luka Lezaic","doi":"10.2478/raon-2024-0058","DOIUrl":"10.2478/raon-2024-0058","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive parathyroidectomy is the treatment of choice in patients with primary hyperparathyroidism (PHP), but it needs a reliable preoperative localization method to detect hyperfunctioning parathyroid tissue. Higher sensitivity and lower radiation exposure was demonstrated for [¹⁸F]fluorocholine PET/CT (FCh-PET/CT) in comparison to [^99mTc]sestamibi (MIBI) scintigraphy. However, data of its efficiency in resource use and patient outcomes is lacking. The aim of our study was to determine the resource efficiency and patient outcomes of FCh-PET/CT in comparison to conventional MIBI scintigraphy.</p><p><strong>Patients and methods: </strong>A group of 234 patients who underwent surgery after MIBI scintigraphy was compared to a group of 163 patients who underwent surgery after FCh-PET/CT. The whole working process from the implementation of imaging to the completion of surgical treatment was analyzed. The economic burden was expressed in the time needed for the required procedures.</p><p><strong>Results: </strong>The time needed to perform imaging was reduced by 83% after FCh-PET/CT in comparison to MIBI scintigraphy. The time needed to perform surgery was reduced by 41% when intraoperative parathyroid hormone monitoring was not used. There was no significant difference in the time of surgery between FCh-PET/CT and MIBI scintigraphy.</p><p><strong>Conclusions: </strong>FCh-PET/CT reduces the time of imaging, the time of surgery and potentially reduces the number of reoperations for persistent disease.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"58 4","pages":"486-493"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The initial results of MRI-TRUS fusion prostate biopsy in high volume tertiary center.","authors":"Tomaz Smrkolj, Milena Taskovska, Iztok Ditz, Klemen Cernelc, Simon Hawlina","doi":"10.2478/raon-2024-0060","DOIUrl":"10.2478/raon-2024-0060","url":null,"abstract":"<p><strong>Background: </strong>Multiparametric magnetic resonance imaging (mpMRI) is a prerequisite for targeted prostate biopsy. The aim of our study was to evaluate the performance and learning curve of the mpMRI-transrectal ultrasound (TRUS) software image fusion (MRI-TRUS fusion) biopsy (BX) process in the first year after its introduction in our urology department.</p><p><strong>Patients and methods: </strong>MRI-TRUS fusion BX was performed in 293 patients with at least one Prostate Imaging-Reporting and Data System (PIRADS) ≥3 lesion. The proportion of patients and lesions with positive histopathologic result for prostate cancer (PCa) was analyzed. The learning curve for MRI-TRUS fusion BX was assessed at institutional and individual level. Positive BX lesions were further analyzed by PIRADS and Gleason scores.</p><p><strong>Results: </strong>The proportion of patients with positive histopathologic results for targeted BX, systematic BX, and combined BX was 53.9%, 47.9%, and 63.5%, respectively. The chi-square test for the proportion of PCa positive patients showed no significant difference between the time-based patient groups at the institutional level and no significant difference between individual urologists. PIRADS score (p < 0.001), total PSA concentration (p = 0.05), prostate volume (p < 0.001) and number of cores per lesion (p = 0.034) were significant predictors of a positive histopathologic result in a lesion-based analysis. Clinically significant PCa (csPCa) was confirmed in 34.7% of the 412 BX lesions and 76.4% of the 187 positive PCa lesions.</p><p><strong>Conclusions: </strong>MRI-TRUS fusion targeted BX significantly improves the overall rate of PCa detection compared with systematic BX alone. No steep learning curve was observed in our urologists. The proportion of lesions with clinically insignificant PCa was low, limiting overdiagnosis of PCa.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"58 4","pages":"501-508"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of right-sided breast cancer adjuvant radiotherapy on the liver.","authors":"Gonca Hanedan Uslu, Filiz Taşçı","doi":"10.2478/raon-2024-0059","DOIUrl":"10.2478/raon-2024-0059","url":null,"abstract":"<p><strong>Background: </strong>In patients with right-sided breast cancer the liver can be partially irradiated during adjuvant radiotherapy (RT). We aimed to determine breast cancer RT effects on liver using with magnetic resonance elastography (MRE) and biological results.</p><p><strong>Patients and methods: </strong>This retrospective study enrolled 34 patients diagnosed with right-sided breast cancer who underwent adjuvant RT. Liver segment assessments were conducted using MRE for all participants. Additionally, a complete blood count and liver enzyme analysis were performed for each patient. All measurements were taken both prior to the initiation and upon completion of RT.</p><p><strong>Results: </strong>A statistically significant difference was found in ALT (p = 0.015), ALP (p = 0.026), total protein (p = 0.037), and albumin (p = 0.004) levels before and after RT. The highest mean liver stiffness (kPa) value was recorded in segment 8, while the lowest was observed in segment 6. A weak but statistically significant positive correlation was found between segment 5 stiffness and liver volume (p = 0.039). Additionally, a statistically significant positive correlation was detected between ALP levels and the stiffness values in segment 4A (p = 0.020) and segment 6 (p = 0.003). Conversely, a weak negative correlation was observed between the stiffness values in segment 8 and post-RT total protein levels (p = 0.031).</p><p><strong>Conclusions: </strong>MRE can help us identify the level of fibrotic stiffness in the liver segments within the RT area without establishing clinical symptoms. MRE can support the clinician in evaluating the liver functions of right breast cancer patients who underwent RT. We assume these results will facilitate new studies with a large number of patients on MRE imaging at certain intervals in the follow-up of patients with right breast cancer who received RT before the development of radiation-induced liver disease (RILD).</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"58 4","pages":"535-543"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-body PET/MRI to detect bone metastases: comparison of the diagnostic performance of the sequences.","authors":"Onur Levent Ulusoy, Sadık Server, Murat Yesilova, Nagihan İnan","doi":"10.2478/raon-2024-0062","DOIUrl":"10.2478/raon-2024-0062","url":null,"abstract":"<p><strong>Background: </strong>Whole-body positron emission tomography/magnetic resonance imaging (WB-PET/MRI) is increasingly used in the initial evaluation of oncology patients. The purpose of this study was to compare the diagnostic performance of WB MRI sequences, attenuation-corrected raw data positron-emission tomography (AC PET), and PET/MRI fused images to detect bone metastases.</p><p><strong>Patients and methods: </strong>We included 765 consecutive oncologic patients who received WB-PET/MRI from between January 2017 and September 2023. The presence of bone metastases was assessed using the individual sequences by two radiologists. Interobserver agreement was calculated. A receiver operating characteristic (ROC) analysis was performed to assess the performance of each individual sequence and fused images.</p><p><strong>Results: </strong>Interobserver agreement for the detection of bone metastases on all sequences ranged from good to very good. The reading of the combination of MRI sequences with PET images showed statistically significantly better performance than the reading of individual MRI sequences and PET component only. Contrast enhanced T1 W Volume-interpolated breath-hold examination (CE T1W VIBE) sequence superior to PET for the detection of bone metastasis, but the statistical significance was not as high as with T1W-PET and CE T1W-PET fused images. The highest performance was achieved by the fused CE T1W-PET images with sensitivity of 100%, specificity of 92%, PPV of 96%, and NPV of 100%.</p><p><strong>Conclusions: </strong>The combination of these CE T1W VIBE sequences with PET images have the highest diagnostic performance in detecting bone metastases in oncologic patients. This sequence should be integrated in WB-PET/MRI acquisitions for initial staging of cancer.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"58 4","pages":"494-500"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late intervention for type II endoleak is not determined by early sac diameter or volume changes after EVAR.","authors":"Bernard Sneyers, Viktor Verbraeken, Annouschka Laenen, Walter Coudyzer, Hozan Mufty, Sabrina Houthoofd, Inge Fourneau, Geert Maleux","doi":"10.2478/raon-2024-0056","DOIUrl":"10.2478/raon-2024-0056","url":null,"abstract":"<p><strong>Background: </strong>To compare the diagnostic accuracy and predictive value of aneurysm sac volume measurement versus maximum diameter measurement of abdominal aortic aneurysm sac after endovascular aneurysm repair (EVAR) in patients with type II endoleak.</p><p><strong>Patients and methods: </strong>Retrospective study on a cohort of 103 patients who presented with a type II endoleak after EVAR for infrarenal abdominal aortic aneurysm. Maximum diameter and volumetric measurements were calculated on computed tomography follow-up scans at 3 months and 1 year after index surgery. Pearson correlation coefficient was used to determine linear association between diameter and volume; Mann-Whitney U test was used to compare patients with and without later intervention for type II endoleak with regard to diameter and volume change.</p><p><strong>Results: </strong>The correlation between diameter and volume measurement was high (Rho: 0.890-0.980 with P < 0.0001). In 38 out of 103 patients (37%) with type II endoleak, a later intervention for endoleak management was performed; early diameter (P = 0.097), or volume (P = 0.387) change could not predict risk for later intervention.</p><p><strong>Conclusions: </strong>Both diameter and volume measurements can be used in the imaging follow-up of patients with endoleak type II after EVAR; however early changes in diameter or volume of the aneurysm sac cannot predict late intervention for type II endoleak.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"58 4","pages":"573-579"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-observer variation in gross tumour volume delineation of oesophageal cancer on MR, CT and PET/CT.","authors":"Ajra Secerov-Ermenc, Primoz Peterlin, Franc Anderluh, Jasna But-Hadzic, Ana Jeromen-Peressutti, Vaneja Velenik, Barbara Segedin","doi":"10.2478/raon-2024-0043","DOIUrl":"10.2478/raon-2024-0043","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study was to assess the inter-observer variability in delineation of the gross tumour volume (GTV) of oesophageal cancer on magnetic resonance (MR) in comparison to computed tomography (CT) and positron emission tomography and CT (PET/CT).</p><p><strong>Patients and methods: </strong>Twenty-three consecutive patients with oesophageal cancer treated with chemo-radiotherapy were enrolled. All patients had PET/CT and MR imaging in treatment position. Five observers independently delineated the GTV on CT alone, MR alone, CT with co-registered MR, PET/CT alone and MR with co-registered PET/CT. Volumes of GTV were measured per patient and imaging modality. Inter-observer agreement, expressed in generalized conformity index (CIgen), volumetric conformity index (VCI), planar conformity index (PCI) and inter-delineation distance (IDD) were calculated per patient and imaging modality. Linear mixed models were used for statistical analysis.</p><p><strong>Results: </strong>GTV volume was significantly lower on MR (33.03 cm³) compared to CT (37.1 cm³; p = 0.002) and on PET/CT MR (35.2 cm³; p = 0.018) compared to PET/CT (39.1 cm³). The CIgen was lowest on CT (0.56) and highest on PET/CT MR (0.67). The difference in CIgen between MR (0.61) and CT was borderline significant (p = 0.048). The VCI was significantly higher on MR (0.71; p = 0.007) and on CT MR (0.71; p = 0.004) compared to CT (0.67). The PCI was significantly higher on CT MR (0.67; p = 0.031) compared to CT (0.64). The largest differences were observed in the cranio-caudal direction.</p><p><strong>Conclusions: </strong>The highest inter-observer agreement was found for PET/CT MR and the lowest for CT. MR could reduce the difference in delineation between observers and provide additional information about the local extent of the tumour.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"580-587"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of exposure to radioactive iodine during a nuclear incident.","authors":"Katja Zaletel, Anamarija Mihovec, Simona Gaberscek","doi":"10.2478/raon-2024-0051","DOIUrl":"10.2478/raon-2024-0051","url":null,"abstract":"<p><strong>Background: </strong>During a nuclear accident, numerous products of nuclear fission are released, including isotopes of radioactive iodine. Among them is iodine-131, with a half-life of 8.02 days, which emits β radiation. For decades, it has been effectively and safely used in medicine. However, in the event of a nuclear accident, uncontrolled exposure can have harmful biological effects. The main sources of internal contamination with iodine-131 are contaminated air, food and water. The most exposed organ is the thyroid gland, where radioactive iodine accumulates via the Na+/I- symporter (NIS). NIS does not distinguish between radioactive iodine isotopes and the stable isotope iodine-127, which is essential for the synthesis of thyroid hormones. Exposure to radioactive iodine during a nuclear accident is primarily associated with papillary thyroid cancer, whose incidence begins to increase a few years after exposure. Children and adolescents are at the highest risk, and the risk is particularly significant for individuals living in iodine-deficient areas.</p><p><strong>Conclusions: </strong>Ensuring an adequate iodine supply is therefore crucial for lowering the risk of the harmful effects of exposure to radioactive iodine at the population level. Protecting the thyroid with potassium iodide tablets significantly reduces radiation exposure, as stable iodine prevents the entry of radioactive iodine into the thyroid. Such protection is effective only within a narrow time window - a few hours before and after the exposure and is recommended only for those under 40 years of age, as the risks of excessive iodine intake outweigh the potential benefits in older individuals.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"459-468"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of chemical-shift and diffusion-weighted magnetic resonance imaging in differentiating malignant and benign vertebral lesions in oncologic patients. A single institution experience.","authors":"Marija B Mijaljevic, Zorica C Milosevic, Slobodan Đ Lavrnic, Zorica M Jokovic, Danica I Ninkovic, Radoje M Tubic, Rajna R Jankovic","doi":"10.2478/raon-2024-0049","DOIUrl":"10.2478/raon-2024-0049","url":null,"abstract":"<p><strong>Background: </strong>To analyze the contribution of two non-standard magnetic resonance imaging (MRI) techniques the chemical-shift image (CSI), and diffusion-weighted imaging (DWI) in distinguishing malignant and benign vertebral bone marrow lesions (VBMLs).</p><p><strong>Patients and methods: </strong>Conventional spine MRI protocol, followed by CSI and DWI was performed with a 1.5 T system on 102 oncologic patients between January 2020 and December 2023. From the identified 325 VBMLs, 102 representative lesions (one per patient) were selected. VBMLs were divided into malignant (n = 74) and benign (n = 28) based on histopathology, or imaging follow-up. The quantitative parameters for VBMLs assessment were signal intensity ratio (SIR) derived from CSI and apparent diffusion coefficient (ADC) derived from DWI.</p><p><strong>Results: </strong>The malignant VBMLs had significantly higher SIR values (p < 0.05) and lower ADC values compared to benign VBMLs (p < 0.05). The area under the curve (AUC) was 0.953 (p < 0.001) for SIR, and 0.894 for ADC (p < 0.001) (cut-off at > 0.82, and ≤ 1.57x10^-3 mm²/s, respectively). The sensitivity and specificity for SIR were 93.6%, and 88.5%, while for ADC were 88.2% and 92.3% (respectively). The combined use of SIR and ADC improved the diagnostic accuracy to AUC of 0.988 (p < 0.001, cut-off at > 0.19), sensitivity, and specificity of 100.0% and 90.9% (respectively).</p><p><strong>Conclusions: </strong>Quantitative parameters, SIR and ADC, derived from two non-standard MRI techniques, CSI, and DWI, showed diagnostic strength in differentiating malignant and benign VBMLs. Combining both methods can further enhance the diagnostic performance and accuracy of spine MRI in clinical practice.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"527-534"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idarubicin-loaded drug-eluting microspheres transarterial chemoembolization for intermediate stage hepatocellular carcinoma: safety, efficacy, and pharmacokinetics.","authors":"Spela Korsic, Josko Osredkar, Alojz Smid, Klemen Steblovnik, Mark Popovic, Igor Locatelli, Jurij Trontelj, Peter Popovic","doi":"10.2478/raon-2024-0052","DOIUrl":"10.2478/raon-2024-0052","url":null,"abstract":"<p><strong>Background: </strong>Transarterial chemoembolization (TACE) is the treatment of choice for the intermediate stage hepatocellular carcinoma (HCC). Doxorubicin remains the most used chemotherapeutic agent in TACE, although <i>in vitro</i> screening has demonstrated that idarubicin exhibits greater cytotoxicity against HCC. This study aimed to evaluate safety, efficacy, and pharmacokinetics of idarubicin-loaded drug-eluting microspheres TACE (DEMIDA-TACE) in intermediate stage HCC patients.</p><p><strong>Patients and methods: </strong>Between September 2019 and December 2021, 31 consecutive intermediate stage HCC patients (96.8% cirrhotic) were included to this study. 2 mL of LifePearl™ microspheres (100 μm) loaded with 10 mg of 1 mg/mL idarubicin were used for treatment. The adverse events, objective response rate (ORR), progression free survival (PFS), time to TACE untreatable progression (TTUP), median overall survival (mOS), and pharmacokinetics were evaluated.</p><p><strong>Results: </strong>There were 68 TACE procedures performed. Adverse events grade ≥ 3 were noted after 29.4% procedures. The ORR was 83.9%, median PFS and TTUP were 10.5 months (95% CI: 6.8-14.3 months) and 24.6 months (95% CI: 11.6-37.6 months), respectively. Median OS was 36.0 months (95% CI: 21.1-50.9 months). Significant differences between patients achieving objective response (OR) and those with progressive disease were observed regarding idarubicinol and combined idarubicin-idarubicinol plasma concentrations at 72 hours post-procedure, higher plasma concentrations were observed in patients achieving OR (p = 0.014 and 0.014; cut-off values 1.2 and 1.29 ng/mL, respectively).</p><p><strong>Conclusions: </strong>DEMIDA-TACE emerges as a safe and effective method of treatment for the intermediate stage HCC with low rates of adverse events alongside high tumor response, favourable disease control and overall survival. Idarubicinol and combined idarubicin-idarubicinol plasma concentrations at 72 hours post-procedure may serve as prognostic factors for achieving OR.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"517-526"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of early diagnostic pathway for prostate cancer in Slovenia.","authors":"Mateja Kokalj Kokot, Spela Mirosevic, Nika Bric, Davorina Petek","doi":"10.2478/raon-2024-0046","DOIUrl":"10.2478/raon-2024-0046","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is a prevalent male malignancy globally. Prolonged diagnostic intervals are associated with poorer outcomes, emphasizing the need to optimize this process. This study aimed to evaluate the doctor and primary care interval, research their impact on patient survival and explore opportunities to improve PCa diagnostic pathway in primary care.</p><p><strong>Patients and methods: </strong>A retrospective cohort study using cancer patients' anonymised primary care data and data of the Slovenian Cancer Registry.</p><p><strong>Results: </strong>The study found that the doctor interval had a median duration of 0 days (interquartile range ([IQR] 0-6) and primary care interval a median duration of 5 days (IQR 0-58). Longer intervals were observed in patients with more than two comorbidities, where general practitioners didn't have access to laboratory diagnostic tests within their primary health care centre and when patients first presented with symptoms (reported symptoms at first presentation: dysuria, lower urinary tract symptoms [LUTS], abdominal pain). The analysis also revealed a statistically significant association between lower 5-year survival rate and the accessibility of laboratory and ultrasound diagnostics in primary healthcare centres and a shorter 5-year survival of symptomatic patients in comparison to patients who were identified by elevated levels of prostate specific antigen (PSA).</p><p><strong>Conclusions: </strong>This study shows that treating suspected PCa in primary care has a significant impact on 5-year survival. Several factors contribute to better survival, including easy access to laboratory and abdominal ultrasound in primary care centres. The study highlights the complex array of factors shaping PCa diagnosis, beyond individual clinicians' skills, encompassing test and service availability.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"544-555"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}