Christian Arsov

Heinrich-Heine-Universität Düsseldorf | HHU · Department of Urology

Background Multiparametric magnetic resonance imaging (mpMRI) may allow patients with prostate cancer (PC) on active surveillance (AS) to avoid repeat prostate biopsies during monitoring. Objective To assess the ability of mpMRI to reduce guideline-mandated biopsy and to predict grade group upgrading in patients with International Society of Urolo...

Objectives: Diffusion weighted imaging (DWI) is the most important sequence for detection and grading prostate cancer (PCa), but it is considerably prone to artifacts. New approaches like zoomed single-shot imaging (z-EPI) with advanced image processing or multi-shot readout segmentation (rs-EPI) try to improve DWI quality. This study evaluates ob...

Background Primary retroperitoneal lymph node dissection (RPLND) for clinical stage (CS) IIA/B seminoma without adjuvant treatment is an experimental treatment to avoid radiotherapy- or chemotherapy-related toxicity from standard treatment. Objective The PRIMETEST trial aimed to prospectively evaluate the oncological efficacy and surgical safety o...

This is a data article from the original publication “Reasons for missing clinically significant prostate cancer by targeted magnetic resonance imaging/ultrasound fusion-guided biopsy” [1]. From January 2014 to April 2019 a sample collective of 785 patients with 3T multiparametric magnetic resonance imaging (mp-MRI) of the prostate and subsequent c...

PROBASE is a population‐based, randomized trial of 46 495 German men recruited at age 45 to compare effects of risk‐adapted prostate cancer (PCa) screening starting either immediately at age 45, or at a deferred age of 50 years. Based on prostate‐specific antigen (PSA) levels, men are classified into risk groups with different screening intervals:...

Purpose This study analyzes the value of dynamic contrast-enhanced MRI (DCE) of the prostate on 1.5T and 3T examinations in patients within PI-RADS category 4. Methods In this retrospective, bi-centric, cohort study all consecutive patients classified as PI-RADS 4 in mpMRI with 100 verified prostate cancers (PCa) in subsequent MRI/US-guided fusion...

ROI Measurements of benign tissue in the peripheral zone (PZ; purple ROI) and transition zone (TZ; orange ROI), and PCA (red ROI). Quantitative T2 map (A), T2 TSE (B), and calculatedadc map of RS‐DWI (C). On Radical prostatectomy (RPE), an ISUP grade 5 PCA was confirmed. by Maximilian Klingebiel et al. (413–422)

Purpose Analysis of patients with pre-operative 3 T multiparametric prostate MRI (mpMRI) to determine reliable MRI-based risk predictors of patients at risk for positive surgical margins (PSM) in robotic assisted radical prostatectomy (RPE). Methods Consecutive patients with 3 T mpMRI and subsequent RPE from 01/2015 to 12/2018 were retrospectively...

To evaluate if follow-up mpMRI scans of patients in PI-RADS category 3 are safe enough to omit or delay prostate biopsy in the future and to determine an optimal control interval. This retrospective single center study includes consecutive PI-RADS category 3 patients with one or more follow-up mpMRI (T2WI, DWI, DCE) and subsequent MRI-targeted and...

Background To assess the diagnostic value of an additional late-phase PET/CT scan after urination as part of ⁶⁸ Ga-PSMA-11 PET/CT for the restaging of patients with biochemically recurrent prostate cancer (BCR). Methods This retrospective trial included patients with BCR following radical prostatectomy, who underwent standard whole-body early-phas...

PURPOSEThis study aims to analyze the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to distinguish between prostate cancer (PCa) and benign lesions in transition zone (TZ) and peripheral zone (PZ) using different methods for arterial input function (AIF) determination. Study endpoints are identification of a...

420 Background: Primary retroperitoneal lymph node dissection (RPLND) in patients (pts) with stage II A/B seminoma without adjuvant local or systemic treatment is an experimental treatment to avoid radio- or chemotherapy–related toxicity. The prospective PRIMETEST trial (NCT 2015053664) evaluates recurrence-free (RFS) and overall survival (OS) as w...

There is no generally accepted screening strategy for prostate cancer (PCa). From February 2014 to December 2019 a randomized trial (PROBASE) recruited 46 642 men at age 45 to determine the efficacy of risk‐adapted prostate‐specific antigen‐based (PSA) screening, starting at either 45 or 50 years. PSA tests are used to classify participants into a...

Background Currently, multi-parametric prostate MRI (mpMRI) consists of a qualitative T2, diffusion weighted, and dynamic contrast enhanced imaging. Quantification of T2 imaging might further standardize PCa detection and support artificial intelligence solutions. Purpose To evaluate the value of T2 mapping to detect prostate cancer (PCa) and to d...

Purpose This study investigates preoperative lymph node metastases (LNM) detection accuracy by MRI and CT in patients with prostate cancer (PCA). Methods All patients with preoperative MRI, CT or both and subsequent radical prostatectomy (RPE) and lymphadenectomy (LA) were included in this retrospective cohort study. Prostate specific antigen (PSA...

Objectives T o evaluate the value of multiparametric MRI (mpMRI) for the prediction of prostate cancer (PCA) aggressiveness. Methods In this single center cohort study, consecutive patients with histologically confirmed PCA were retrospectively enrolled. Four different ISUP grade groups (1, 2, 3, 4–5) were defined and fifty patients per group were...

Purpose To evaluate image quality and diagnostic value of multiparametric prostate MRI (mpMRI) in patients with total hip replacement (THR) at 1.5 and 3 Tesla. Methods In this retrospective multicenter cohort study patients with uni- or bilateral THR and 1.5T or 3T mpMRI were included. Seventy consecutive, standard-of-care examinations per field s...

Objectives The aim of this study was to investigate 3 Tesla multiparametric magnetic resonance imaging (mpMRI)-based predictors for the pretherapeutic T staging of prostate cancer and their accuracy. Methods Consecutive patients with 3 Tesla mpMRI, positive systematic and MR-targeted biopsy, and subsequent radical prostatectomy (RPE) between 01/20...

Purpose: To determine the capability of Gadolinium-free arterial spin labelling (ASL) sequences as novel, contrast-free, non-invasive alternative perfusion imaging method to differentiate prostate cancer (PCA) from benign prostate tissue compared to conventional DCE MRI. Methods: Thirty men with histologically confirmed PCA were included in this...

Dynamic contrast enhanced imaging (DCE) as an integral part of multiparametric prostate magnet resonance imaging (mpMRI) can be evaluated using qualitative, semi-quantitative, or quantitative assessment methods. Aim of this study is to analyze the clinical benefits of these evaluations of DCE regarding clinically significant prostate cancer (csPCa)...

Background Prostate cancer (PCa) is the most common cancer and the second leading cause of cancer death in men in industrialized countries. There is no commonly accepted prostate cancer screening strategy. Based on the experience of various international screening studies, the German Prostate Cancer Early Detection Study Based on a Baseline PSA Val...

Objectives This study evaluates cases with clinically significant prostate cancer (csPCa) missed by targeted biopsy (TB) and analyzes the diagnostic impact of an additional systematic biopsy (SB) in a large patient collective. Methods Consecutive patients with a 3 T multiparametric prostate MRI (mpMRI) and a subsequent MRI/US fusion-guided TB plus...

Objectives To compare prostate specific membrane antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) and computed tomography (CT) alone for the detection of biochemical recurrence of prostate cancer (PCa) and effect on treatment. Methods This retrospective study included 59 patients with recently recorded biochemical recurrenc...

We aimed to investigate the relation between largest lesion diameter, prostate-specific antigen density (PSA-D), age, and the detection of clinically significant prostate cancer (csPCa) using first-time targeted biopsy (TBx) in men with Prostate Imaging—Reporting and Data System (PI-RADS) 3 index lesions. A total of 292 men (2013–2019) from two ref...

Purpose: Robotic-assisted retroperitoneal lymph node dissection (R-RPLND) in patients with testicular cancer (TC) is controversially discussed. Lately, unusual recurrence patterns with adverse outcome have been published after R-RPLND. Aim of this report is to determine the feasibility, safety and early oncological outcome of R-RPLND in patients w...

Purpose This study evaluates objective and subjective image quality (IQ) of three different diffusion weighted imaging (DWI) sequences in prostate MRI at 3.0 Tesla within the same patients. Method Thirty-six consecutive patients (70 ± 8 years) with multi-parametric prostate MRI (mp-MRI; 3 T) and subsequently verified prostate cancer (PCa) by targe...

Objectives To assess the ability of multiparametric MRI (mp-MRI) of the prostate to exclude prostate cancer (PCa) progression during monitoring patients on active surveillance (AS).Methods One hundred forty-seven consecutive patients on AS with mp-MRI (T2WI, DWI, DCE-MRI) at 3T were initially enrolled. Fifty-five received follow-up mp-MRI after a m...

Objective To assess the impact of dynamic contrast-enhanced imaging (DCE) in mp-MRI on prostate cancer (PCa) detection in a large patient cohort assigned to PI-RADS category 4. Method This retrospective, single center cohort study includes 193 consecutive patients with PI-RADS assessment category 4 in mp-MRI (T2WI, DWI, DCE) at 3 T with targeted pl...

Objectives To report pre-, postoperative and oncological outcomes in patients treated with spot-specific sLND for patients with exclusive nodal recurrence after PCa primary treatment. Materials and methods With regard to salvage treatment failure (sTF), 46 consecutive patients, undergoing 52 sLND for nodal recurrence detected by PET/CT scan were s...

Introduction: Although low sexual desire is 1 of the most common sexual dysfunctions in men, there is a lack of studies investigating associated factors in large, population-based samples of middle-aged men. Aim: To survey the prevalence of low sexual desire in a population-based sample of 45-year-old German men and to evaluate associations with...

Objectives To evaluate different analgesic techniques in MRI-guided in-bore prostate biopsy (IB-GB) regarding the influence on patient procedural experience of pain. Methods Two hundred fifty-two consecutive patients who had received an IB-GB either with intrarectal instillation of 2% lidocaine gel (n = 126, group A) or with periprostatic nerve bl...

Background Prostate cancer (PCA) is the most common type of cancer in men. The significant increase in incidence is most likely caused by the overdiagnosis of prostate cancer by widespread prostate-specific antigen (PSA) screening. Objectives This article reviews the three largest randomized trials of PSA-based prostate cancer screening and the be...

Purpose To evaluate if subgroups of patients assigned to MRI category PI-RADS 4 regarding clinical and MRI imaging aspects have distinct risks of prostate cancer (PCa) to facilitate adequate clinical management of this population, especially after negative targeted biopsy. Methods This prospective, IRB approved single center cross-sectional study...

Background Erectile dysfunction (ED) is a common public health issue with a significant impact on quality of life. The associations between ED and several risk factors have been reported previously. The continuously increasing incidence of these factors is contributing to the increasing prevalence of ED. Aim To assess ED prevalence and severity in...

Prostate cancer is the most common cancer among men in industrialized countries. The annual incidence rate in Germany is about 60,000. Every year, 13,000 men die of this disease. Nevertheless, the 10-year survival rate is relatively favorable compared to other carcinomas. Prostate cancer screening is discussed controversially both nationally and in...

Introduction: Discordance of various aspects of sexual orientation has been mostly studied in young adults or in small samples of heterosexual men. Studies focusing on concordance and discordance of aspects of sexual orientation in representative samples of middle-aged men including homosexual men are scarce. Aim: To investigate concordant and d...

Background: The Rotterdam European Randomized Study of Screening for Prostate Cancer risk calculators (ERSPC-RCs) help to avoid unnecessary transrectal ultrasound-guided systematic biopsies (TRUS-Bx). Multivariable risk stratification could also avoid unnecessary biopsies following multiparametric magnetic resonance imaging (mpMRI). Objective: T...

Purpose: Reproducibility of quantitative perfusion analysis of DCE requires a standardized AIF acquisition. However, there are many different approaches for AIF assessment so that the absolute values of perfusion parameters may vary depending on the used method. This study analyzes the influence of the method of AIF determination on quantitative D...

Purpose: For multiparametric MRI/Ultrasound fusion prostate biopsy (FUSBx) the number of taken biopsy cores is arbitrary established by urologists. Moreover, general consensus on the number of biopsy cores to be obtained from a single MRI-lesion is lacking. Therefore, we aimed to evaluate the feasibility of obtaining only one biopsy core per MRI-l...

Purpose To assess the current regional acceptance, valuation, and clinical role of multiparametric MRI (mp-MRI) in prostate cancer diagnostics by patients and physicians. Materials and Methods Of 482 distributed standardized questionnaires, 328 patient and 31 physician questionnaires (urological and general practitioners in and around Düsseldorf) w...

Die PSA-basierte Prostatakarzinomfrüherkennung steht trotz nachgewiesener Reduktion der prostatakarzinomspezifischen Mortalität um 27 % aufgrund der noch relativ hohen Rate an Überdiagnostik und Übertherapie weiterhin in der Kritik. Neuere Daten zur Wertigkeit eines frühen Basis-PSA-Werts im Alter von 45 bis 50 Jahren, klinische Risikofaktoren und...

Purpose: To systematically analyze patients with PI-RADS-3-lesions (called 'equivocal' according to PI-RADS v2) in multiparametric prostate MRI (mp-MRI) and MR-targeted plus systematic transrectal ultrasound-guided (TRUS-GB) biopsies as reference standard. Material and methods: One hundred and twenty consecutive patients with a PI-RADS overall s...

Objectives: To prospectively evaluate the effect of hyoscine butylbromide (HBB) on visualisation of anatomical details and motion-related artefacts in mp-MRI of the prostate at 3.0 Tesla. Methods: One hundred and three consecutive patients (65 ± 10 years) were included in this trial, powered to demonstrate an improvement of image quality after H...