***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE We determined the prostate cancer detection rate of multiparametric magnetic resonance imaging at 3 T . Precise one-to-one histopathological correlation with magnetic resonance imaging was possible using prostate magnetic resonance imaging based custom printed specimen molds after radical prostatectomy . MATERIAL S AND METHODS This institutional review board approved prospect i ve study included 45 patients ( mean age 60.2 years , range 49 to 75 ) with a mean prostate specific antigen of 6.37 ng/ml ( range 2.3 to 23.7 ) who had biopsy proven prostate cancer ( mean Gleason score of 6.7 , range 6 to 9 ) . Before prostatectomy all patients underwent prostate magnetic resonance imaging using endorectal and surface coils on a 3 T scanner , which included triplane T2-weighted magnetic resonance imaging , apparent diffusion coefficient maps of diffusion weighted magnetic resonance imaging , dynamic contrast enhanced magnetic resonance imaging and spectroscopy . The prostate specimen was whole mount sectioned in a customized mold , allowing geometric alignment to magnetic resonance imaging . Tumors were mapped on magnetic resonance imaging and histopathology . Sensitivity , specificity , positive predictive value and negative predictive value of magnetic resonance imaging for cancer detection were calculated . In addition , the effects of tumor size and Gleason score on the sensitivity of multiparametric magnetic resonance imaging were evaluated . RESULTS The positive predictive value of multiparametric magnetic resonance imaging to detect prostate cancer was 98 % , 98 % and 100 % in the overall prostate , peripheral zone and central gl and , respectively . The sensitivity of magnetic resonance imaging sequences was higher for tumors larger than 5 mm in diameter as well as for those with higher Gleason scores ( greater than 7 , p < 0.05 ) . CONCLUSIONS Prostate magnetic resonance imaging at 3 T allows for the detection of prostate cancer . A multiparametric approach increases the predictive power of magnetic resonance imaging for diagnosis . In this study accurate correlation between multiparametric magnetic resonance imaging and histopathology was obtained by the patient specific , magnetic resonance imaging based mold technique Background : Identification of men harbouring insignificant prostate cancer ( PC ) is important in selecting patients for active surveillance . Tools have been developed in PSA-screened population s to identify such men based on clinical and biopsy parameters . Methods : Prospect ively collected case series of 848 patients was treated with radical prostatectomy between July 2007 and October 2011 at an English tertiary care centre .  Tumour volume was assessed by pathological examination . For each tool , receiver operator characteristics were calculated for predicting insignificant disease by three different criteria and the area under each curve compared . Comparison of accuracy in screened and unscreened population s was performed . Results : Of 848 patients , 415 had Gleason 3 + 3 disease on biopsy . Of these , 32.0 % had extra-prostatic extension and 50.2 % were up grade d. One had positive lymph nodes . Two hundred and six ( 24 % of cohort ) were D’Amico low risk . Of these , 143 had more than two biopsy cores involved . None of the tools evaluated has adequate discriminative power in predicting insignificant tumour burden . Accuracy is low in PSA-screened and -unscreened population s. Conclusions : In our unscreened population , tools design ed to identify insignificant PC are inaccurate . Detection of a wider size range of prostate tumours in the unscreened may contribute to relative inaccuracy A variety of malignant neoplasms have been shown to induce capillary neovascularization , and in some cases the degree of vascularization appears to correlate with aggressive behavior and risk of metastasis . We hypothesized that carcinoma of the prostate also induces the formation of new capillaries , and we developed a method to quantify the relative density of microscopic vessels in carcinoma of the prostate compared with benign prostatic gl and ular tissue . The number of microvessel profiles in tissue sections was quantified by marking the vascular endothelial cells with antibodies to factor VIII-related antigen using st and ard immunohistochemistry techniques and comparing fields of adenocarcinoma with benign gl and ular tissue in 15 radical prostatectomy specimens . The analysis was facilitated by using the Optimas computerized image analysis system ( Bioscan , Seattle , WA ) with software written for this investigation . Fourteen of the 15 cases demonstrated significantly higher vascular density in the areas of carcinoma than in the benign tissues . Overall , the ratio of vessels per unit area in sections of carcinoma versus benign tissue was approximately double ( ratio = 2.02 ; P < .001 ) . In benign tissues the capillaries are restricted for the most part to the perigl and ular stroma immediately adjacent to the epithelium , whereas the distribution in carcinoma appears to be more r and om . The data demonstrate the increased density of capillaries in prostatic carcinoma when compared with benign prostate tissue PURPOSE We evaluated biochemical parameters and pathological features , as well as biopsy related morbidity of prostate cancer detected on biopsies 2 , 3 and 4 in men with total serum prostate specific antigen ( PSA ) between 4 and 10 ng./ml . These features were compared to those detected on prostate biopsy 1 . MATERIAL S AND METHODS In this prospect i ve European Prostate Cancer Detection study 1,051 men with total PSA between 4 and 10 ng./ml . underwent transrectal ultrasound guided sextant biopsy and 2 additional transition zone biopsies .  All patients in whom biopsy sample s were negative for prostate cancer underwent biopsy 2 after 6 weeks . If also negative , biopsies 3 and even 4 were performed at 8-week intervals . Those patients with clinical ly localized cancer underwent radical prostatectomy . Pathological and clinical features of patients diagnosed with cancer on either biopsy 1 or 2 and clinical ly organ confined disease who agreed to undergo radical prostatectomy were compared . RESULTS Cancer detection rates on biopsies 1 , 2 , 3 and 4 were 22 % ( 231 of 1,051 ) , 10 % ( 83 of 820 ) , 5 % ( 36 of 737 ) and 4 % ( 4 of 94 ) , respectively . Overall , of the patients with clinical ly localized disease , which was 67 % of cancers detected , 86 % underwent radical prostatectomy and 14 % opted for watchful waiting or radiation therapy . Overall , 58.0 % , 60.9 % , 86.3 % and 100 % of patients had organ confined disease on biopsies 1 , 2 , 3 and 4 , respectively . Despite statistically significant differences in regard to multifocality ( p = 0.009 ) and cancer location ( p = 0.001 ) , including cancer on biopsy 2 showing a lower rate of multifocality and a more apico-dorsal location , there were no differences in regard to stage ( p = 0.2 ) , Gleason score ( p = 0.3 ) , percent Gleason grade 4/5 ( p = 0.2 ) , serum PSA and patient age between biopsies 1 and 2 . However , cancer detected on biopsies 3 and 4 had a significantly lower Gleason score ( p = 0.001 and 0.001 ) , lower rate of grade 4/5 ( p = 0.02 ) , and lower volume ( p = 0.001 and 0.001 ) and stage ( p = 0.001 ) , respectively . CONCLUSIONS Despite differences in location and multifocality , pathological and biochemical features of cancer detected on biopsies 1 and 2 were similar , suggesting comparable biological behaviors . Cancer detected on biopsies 3 and 4 had a lower grade , stage and volume compared with that on biopsies 1 and 2 . Morbidity on biopsies 1 and 2 was similar , whereas biopsies 3 and 4 had a slightly higher complication rate . Therefore , biopsy 2 in all cases of a negative finding on biopsy 1 appears justified . However , biopsies 3 and 4 should only be obtained in select patients with a high suspicion of cancer and /or poor prognostic factors on biopsy 1 or 2 Background Following publication of the PRISMA statement , the UK Centre for Review s and Dissemination ( CRD ) at the University of York in Engl and began to develop an international prospect i ve register of systematic review s with health-related outcomes . The objectives were to reduce unplanned duplication of review s and provide transparency in the review process , with the aim of minimizing reporting bias . Methods An international advisory group was formed and a consultation undertaken to establish the key items necessary for inclusion in the register and to gather views on various aspects of functionality . This article describes the development of the register , now called PROSPERO , and the process of registration . Results PROSPERO offers free registration and free public access to a unique prospect i ve register of systematic review s across all areas of health from all around the world . The dedicated web-based interface is electronically search able and available to all prospect i ve registrants . At the moment , inclusion in PROSPERO is restricted to systematic review s of the effects of interventions and strategies to prevent , diagnose , treat , and monitor health conditions , for which there is a health-related outcome .Ideally , registration should take place before the research ers have started formal screening against inclusion criteria but review s are eligible as long as they have not progressed beyond the point of completing data extraction .The required data set captures the key attributes of review design as well as the administrative details necessary for registration .Su bmi tted registration forms are checked against the scope for inclusion in PROSPERO and for clarity of content before being made publicly available on the register , rejected , or returned to the applicant for clarification . The public records include an audit trail of major changes to planned methods , details of when the review has been completed , and links to result ing publications when provided by the authors . Conclusions There has been international support and an enthusiastic response to the principle of prospect i ve registration of protocol s for systematic review s and to the development of PROSPERO .In October 2011 , PROSPERO contained 200 records of systematic review s being undertaken in 26 countries around the world on a diverse range of interventions Background and purpose The aim of this work was to determine whether 11C-choline positron emission tomography (PET)–computed tomography ( CT ) makes a positive contribution to multiparametric magnetic resonance imaging ( MRI ) for localisation of intraprostatic tumour nodules . Patients and methods A total of 73 patients with biopsy-proven intermediate- and high-risk prostate cancer were enrolled in a prospect i ve imaging study consisting of T2-weighted ( T2w ) , dynamic contrast-enhanced ( DCE ) and diffusion-weighted ( DW ) MRI and 11C-choline PET-CT before radical prostatectomy . Cancerous regions were delineated on the whole-mount prostatectomy sections and on the different MRI modalities and analysed in 24 segments per patient ( 3 sections , 8 segments each ) . To analyse PET-CT images , st and ardized uptake values ( SUV ) were calculated per segment . Results In total , 1,752 segments were analyzed of which 708 ( 40.4 % ) were found to be malignant . A high specificity ( 94.7 , 93.6 and 92.2 % ) but relatively low sensitivity ( 31.2 , 24.9 and 44.1 % ) for tumour localisation was obtained with T2w , DCE and DW MRI , respectively . Sensitivity values significantly increased when combining all MRI modalities ( 57.2 % ) . For PET-CT , mean SUVmax of malignant octants was significantly higher than mean SUVmax of benign octants ( 3.68 ± 1.30 vs. 3.12 ± 1.02 , p < 0.0001 ) . In terms of accuracy , the benefit of adding PET-CT to ( multiparametric ) MRI was less than 1 % . Conclusion The additional value of 11C-choline PET-CT to MRI in localising intraprostatic tumour nodules is limited , especially when multiparametric MRI is used . ZusammenfassungHintergrund und ZielEs galt festzustellen , ob die 11C-Cholin-Positronenemissionstomographie-Computertomographie ( 11C-Cholin-PET-CT ) bei der multiparametrischen Magnetresonanztomographie ( MR ) für die Lokalisierung von intraprostatischen Tumorknoten einen Mehrwert darstellt . Patienten und Method ikInsgesamt 73 Patienten mit durch Biopsie nachgewiesenem Prostatakarzinom von mittlerem und hohem Risiko nahmen an einer prospektiven bildgebenden Studie , bestehend aus T2-gewichteter ( T2w ) , dynamischen Kontrast- ( DCE ) und diffusionsgewichteter ( DW ) MR und 11C-Cholin-PET-CT vor radikaler Prostatektomie , teil . Krebsartige Regionen wurden auf den „ Whole-mount“-Prostatektomieschnitten und auf den verschiedenen MR-Modalitäten abgegrenzt . Pro Patient wurden 24 Segmente analysiert ( 3 Schnitte mit jeweils 8 Segmenten ) . Um PET-CT-Bilder zu analysieren , wurden st and ardisierte Uptake-Values ( SUV ) pro Segment berechnet . ErgebnisseInsgesamt wurden 1752 Segmente analysiert , wovon 708 ( 40,4 % ) als bösartig klassifiziert wurden . Mit T2w , DCE und DW-MR wurde jeweils eine hohe Spezifität ( 94,7 % , 
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In conclusion , DCE had relatively high specificity in detecting PCa but relatively low sensitivity as a complementary functional method .
DCE-MRI might help clinicians exclude cases of normal tissue and serve as an adjunct to conventional imaging when seeking to identify tumor foci in patients with PCa