title: Sextant-Specific Analysis of Detection and Tumor Volume by HistoScanning™.
abstract: BACKGROUND
  Published results of HistoScanning™ (HS) for prostate cancer (PCa) diagnostics are inconsistent and their value remains unclear. We prospectively analyzed the detection rate and tumor volume concordance in PCa patients.
  
  
  METHODS
  Two hundred and eighty-two patients with biopsy-proven PCa scheduled for radical prostatectomy (RP) were included. All patients underwent ultrasonographical examination by HS prior to surgery. HS was evaluated compared to RP specimen as to (1) the prediction of overall tumor volume and (2) accuracy of HS in detection of PCa lesions larger than 0.2/0.5 ml, separated for each sextant. For each sextant, receiver operating characteristic (ROC)-analysis and area under the curve were determined. Sensitivity and specificity were calculated and visualized in ROC-curves.
  
  
  RESULTS
  HS tends to underestimate volume of cancerous lesions, particularly larger lesions >8 ml. Using a 0.2 ml detection threshold, specificity and sensitivity of HS were between 29-68% and 46-78%. For a 0.5 ml detection threshold, sextant-specific specificity increased to 59-92% and sensitivity decreased to 16-54%. Stratification according to pre-operational PSA values did not improve performance characteristics of HS.
  
  
  CONCLUSIONS
  Our results do not support a significant contribution of HS to PCa diagnostics.
authors.affiliation: Department of Urology, RWTH University, Aachen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Porres
authors.forename: Timur Hasan
authors.initials: TH
authors.lastname: Kuru
authors.forename: Robin
authors.initials: R
authors.lastname: Epplen
authors.forename: Andreas
authors.initials: A
authors.lastname: Eck
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Lieven Niels
authors.initials: LN
authors.lastname: Kennes
authors.forename: Samir
authors.initials: S
authors.lastname: Afram
authors.forename: Till
authors.initials: T
authors.lastname: Braunschweig
authors.forename: Ruth
authors.initials: R
authors.lastname: Knüchel-Clarke
authors.forename: David
authors.initials: D
authors.lastname: Pfister
authors.forename: Axel
authors.initials: A
authors.lastname: Heidenreich
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012372:ROC Curve; D015203:Reproducibility of Results; D047368:Tumor Burden; D014463:Ultrasonography / Q000379:methods*