JU open plus最新文献

{"title":"Population-Specific Radiomics From Biparametric Magnetic Resonance Imaging Improves Prostate Cancer Risk Stratification in African American Men.","authors":"Abhishek Midya, Sreeharsha Tirumani, Leonardo Kayat Bittencourt, Sena Azamat, Siddharth Balakrishnan, Amogh Hiremath, Sarah Wido, Pingfu Fu, Lee Ponsky, Anant Madabhushi, Rakesh Shiradkar","doi":"10.1097/ju9.0000000000000310","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000310","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify population-specific differences in prostate cancer (PCa) presentation between African American (AA) and White (W) men on MRI using radiomics.</p><p><strong>Materials and methods: </strong>We identified N = 149 men with PCa who underwent 3T MRI, a confirmatory biopsy and for whom self-reported race was available. Patient studies were partitioned into training (D_Tr) and hold-out test set (D_Te). Three hundred radiomic features quantifying textural patterns were extracted from radiologist delineated PCa regions of interest (ROI) on biparametric MRI. Features with significant differences (<i>P</i> < .05) between clinically significant (csPCa) and insignificant (ciPCa) PCa were identified. Machine learning models were trained separately for AA and W men (C_AA, C_W) on D_Tr to distinguish csPCa and ciPCa. Validation on D_Te was assessed for AUC and compared against a population agnostic model (C_PA) in combination with clinical parameters (age, PSA, Prostate Imaging Reporting and Diagnostic System and tumor volume).</p><p><strong>Results: </strong>Radiomic features from PCa ROIs on biparametric MRI associated with csPCa were observed to be different in AA compared with W men, especially in the peritumoral region. Population-specific radiomic models outperformed similarly trained C_PA models (AUC = 0.84, 0.57 with C_AA, C_PA; <i>P</i> < .05) in AA men on D_Te. Similar findings were observed for W men (AUC = 0.71, 0.60 with C_W, C_PA; <i>P</i> < .05). Integrating clinical and radiomics further improved the risk stratification for AA men (AUC = 0.90) and W men (AUC = 0.75).</p><p><strong>Conclusions: </strong>Accounting for population-specific differences in radiomics may enable improved PCa risk stratification at MRI among AA men compared with a population agnostic approach.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"3 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JUOP April 2025: Report on the Third Annual CUReS Symposium-Collaborative Urology Research Symposium at Houston Methodist.","authors":"Zachary B Kahlenberg, Johnny Su, Raj Satkunasivam, Betsy H Salazar, Jennifer M Taylor, Steven E Canfield, Joseph Sonstein, Patrick Lowry, John W Davis, Rose Khavari","doi":"10.1097/ju9.0000000000000309","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000309","url":null,"abstract":"<p><p>For our monthly editorial series, we are featuring highlights of key academic meetings as a potential review topic, and the editorial board is planning additional content that will feature and illustrate key AUA guidelines into presentation quality formats. For this month, we received this excellent write up of a recent collaborative symposium (basically all authors listed except me) and include it with minimal edits below.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"3 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drive Time to Physicians and Outcomes for Bladder Cancer.","authors":"Sruthi L Muluk, Coleman Drake, Zhaojun Sun, Manisha Bhattacharya, Bruce L Jacobs, Lindsay M Sabik","doi":"10.1097/ju9.0000000000000273","DOIUrl":"10.1097/ju9.0000000000000273","url":null,"abstract":"<p><strong>Purpose: </strong>For patients with muscle-invasive bladder cancer (MIBC), time to cystectomy and receipt of neoadjuvant chemotherapy are associated with improved survival. Travel burden may be an important barrier to timely guideline-concordant treatment.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional study of patients in Pennsylvania with a first lifetime cancer diagnosis of MIBC who underwent radical cystectomy at non-federal short-term general hospitals identified in 2010-2016 Pennsylvania Cancer Registry linked to Pennsylvania Healthcare Cost Containment Council (PHC4) inpatient data through 2018. Physician location came from the Centers for Medicare and Medicaid Services.</p><p><strong>Results: </strong>Mean (standard deviation) drive time to nearest oncologist was 17.1 (11.4) minutes and to nearest urologist was 13.9 (9.2) minutes. A 30-minute increase in drive time to the urologist was associated with a 12.5 percentage point lower likelihood of undergoing cystectomy within 90 days (95% CI: -24.3 to -0.6), with greater effects for more socioeconomically disadvantaged areas (18.7 percentage point lower [95% CI: -33.1 to -4.3]). A 30-minute increase to the oncologist was associated with an 11.9 percentage point lower likelihood of receiving neoadjuvant chemotherapy (95% CI: -23.4 to -0.4). Drive time was not significantly associated with 90-day mortality or readmission.</p><p><strong>Conclusions: </strong>Drive time to oncologists and urologists is associated with timely receipt of guideline-recommended care for patients with MIBC. Understanding the impact of geographic access on clinical outcomes for patients with cancer who require multispecialty care can inform providers and policymakers in efforts to improve cancer care access and outcomes.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Reductions in Prostate-Specific Antigen Screening During the COVID-19 Pandemic in a Universally Insured American Health System","authors":"Daisy Obiora, Bruce L. Jacobs","doi":"10.1097/ju9.0000000000000160","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000160","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"56 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Telehealth in Urology Beyond COVID-19","authors":"K. Kieran","doi":"10.1097/ju9.0000000000000168","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000168","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"261 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Bladder Melanosis Diagnosed Simultaneously With Urothelial Carcinoma: A Case Report and Literature Review","authors":"Erin Ellison, Lauren Faber, Carolyn Ice, Joseph Glass, Jessica Ming, Michael J. Martinez","doi":"10.1097/ju9.0000000000000174","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000174","url":null,"abstract":"Melanosis is a rare entity described as brown-black tissue pigmentation secondary to melanin deposition. Presented here is the third reported case of melanosis diagnosed simultaneously with urothelial carcinoma of the bladder. This is only the sixth case associating melanosis with malignancy. The patient is a 78-year-old man who presented with lower urinary tract symptoms and on cystoscopy, was noted to have diffused brown-black bladder pigmentation. Initial pathology showed squamous cell carcinoma with melanosis present. The patient underwent robotic cystectomy with ileal conduit and on final pathology, had urothelial carcinoma with squamous differentiation. A literature review was performed for both benign-associated and malignant-associated melanosis. The review elucidated that melanosis may herald malignancy in 16% of available reported cases, suggesting even a patient with benign melanosis should undergo surveillance.","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"36 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a Reconstructive Ladder for Surgical Reconstruction of Transplant Ureteral Stricture Disease","authors":"Emily Ji, Jonathan Rosenfeld, Devin Boehm, Rebecca Arteaga, Aidan Raikar, Jaewoo Kim, Ziho Lee","doi":"10.1097/ju9.0000000000000163","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000163","url":null,"abstract":"\u0000 \u0000 Reconstruction of transplant ureteral stricture disease (USD) is a challenging surgical problem. In this article, we review our reconstructive ladder for robotic reconstruction of transplant USD and report our outcomes.\u0000 \u0000 \u0000 \u0000 We performed a retrospective review of patients undergoing robotic transplant reimplantation for USD after kidney transplantation at our institution between 11/2021 and 3/2023. Only patients with at least 1-year follow-up were included. The first rung of our reconstructive ladder is a side-to-side nontransecting reimplant. We prefer this method whenever possible because it avoids transection of the ureter, preserving the fragile blood supply. When this technique is not possible, because of long stricture length and/or limited bladder mobility, we proceed to the second rung of our reconstructive ladder, a Boari flap reconstruction. Surgical success in our cohort was defined as being hardware-free without evidence of ureteral obstruction on imaging.\u0000 \u0000 \u0000 \u0000 There were 6 patients in our cohort: 3 underwent side-to-side reconstruction and 3 underwent Boari flap reconstruction. Median console time was 139 minutes (interquartile range [IQR] 85-175), estimated blood loss was 25 milliliters (IQR 25-81), and length of stay was 1 day (IQR 1-3). We had one major (Clavien ≥ III) complication, which was an intensive care unit transfer postoperatively for hypertension requiring a nicardipine drip. Median follow-up was 14 months (IQR 13-18) with a 100% surgical success rate.\u0000 \u0000 \u0000 \u0000 Utilization of a reconstructive ladder for management of transplant USD may allow for a systematic approach based on reconstructive principles. Our approach was associated with excellent intermediate-term outcomes.\u0000","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Synchronous Insertion of Hyaluronic Acid-Based Biodegradable Rectal Spacer for Primary Prostate Cryotherapy","authors":"Mikolaj J. Filon, Bogdana Schmidt","doi":"10.1097/ju9.0000000000000173","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000173","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"233 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous Insertion of Hyaluronic Acid-Based Biodegradable Rectal Spacer for Primary Prostate Cryotherapy","authors":"Nigel J. Parr, Timothy Dudderidge","doi":"10.1097/ju9.0000000000000169","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000169","url":null,"abstract":"\u0000 \u0000 Recently, biodegradable spacers have been introduced to reduce rectal wall toxicity during external beam radiotherapy for prostate cancer. Rectal wall damage with fistula formation is a major complication of primary and salvage prostate cryotherapy. In theory, biodegradable spacers can be used to protect the rectum from the damage associated with cryotherapy. We describe a case of rectal spacer insertion for primary cryotherapy in a patient with high-risk localized prostate cancer who was unsuitable for other radical treatments because of previous treatment of rectal cancer, detailing the rationale for spacer selection, technique, and outcomes.\u0000 \u0000 \u0000 \u0000 A 57-year-old man was referred, following a regional specialist multidisciplinary team discussion, for an opinion regarding possible primary prostate cryotherapy. He had a history of anterior resection with chemoradiotherapy, followed by local relapse treated with total colectomy with ileoanal pouch formation and suffering from major postoperative complications. After further assessment and because of concern regarding damage to the efferent pouch limb during freezing, the possibility of spacer insertion between the ileoanal segment was considered and discussed. A hyaluronic acid gel spacer was selected and offered “off licence” on a compassionate basis. The spacer was introduced immediately before cryotherapy.\u0000 \u0000 \u0000 \u0000 Recovery was uncomplicated apart from transient intermittent perineal pain, with good early functional and oncological outcomes.\u0000 \u0000 \u0000 \u0000 This is the first report of synchronous insertion of a hyaluronic acid gel spacer in prostate cryotherapy. We believe that the technique merits further investigation, with the potential to reduce complications and enhance freezing of the posterior aspect of the gland during cryotherapy.\u0000","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Urinary Bladder Melanosis Diagnosed Simultaneously With Urothelial Carcinoma: A Case Report and Literature Review","authors":"Alfredo Aliaga, Mario I. Fernández","doi":"10.1097/ju9.0000000000000179","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000179","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"40 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}