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Digital rectal examination in a simulated environment using sweeping palpation and mechanical localization

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Abstract

Computerized palpation systems have been studied for the quantitative characterization of prostate properties. The aim of this study was to evaluate the reliability of mechanical tumor localization maps by estimating correlation with pathological maps. A total of 120 indentations were performed on 10 specimens by using a sweeping palpation system in simulated environment conditions. Suspicious tumor lesions from the mechanical localization were compared to those of the pathological maps. The concordance rate between the mechanical localization maps and pathological maps was 81.7% (98/120). The positive predictive value (PPV) and the negative predictive value (NPV) of the proposed localization system were 78.6% (59/75) and 86.7% (39/45), respectively. Based on these data, the suspicious tumor lesions of mechanical localization maps were in close agreement with those from the pathological maps. The findings suggest that the high compatibility and detection rate of prostate tumor could be enhanced if computerized palpation and the conventional diagnosis are used synergistically. This study may contribute to technological progress in overcoming diagnostic limitations, which include many complications from digital rectal examination (DRE) and transrectal ultrasound (TRUS) guided needle biopsy.

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References

  1. Ramon, J. and Denis, L. J., “Prostate Cancer: Recent Results in Cancer Research,” Springer, 2007.

    Google Scholar 

  2. Byar, D. P. and Mostofi, F. K., “Carcinoma of the Prostate: Prognostic Evaluation of Certain Pathologic Features in 208 Radical Prostatectomies,” Cancer, Vol. 30, No. 1, pp. 5–13, 1972.

    Article  Google Scholar 

  3. Catalona, W. J., Smith, D. S., Ratliff, T. L., Dodds, K. M., Coplen, D. E., and et al., “Measurement of Prostate-Specific Antigen in Serum as a Screening Test for Prostate Cancer,” New England Journal of Medicine, Vol. 324, No. 17, pp. 1156–1161, 1991.

    Article  Google Scholar 

  4. Brawer, M. K., Chetner, M. P., Beatie, D. M., Vessella, R. L., and Lange, P. H., “Screening for Prostatic Carcinoma with Prostate Specific Antigen,” Journal of Urology, Vol. 147, No. 3, pp. 841–845, 1992.

    Google Scholar 

  5. Partin, A. W., Catalona, W. J., Southwick, P. C., Subong, E. N., Gasior, G. H., and Chan, D. W., “Analysis of Percent Free Prostate-Specific Antigen (PSA) for Prostate Cancer Detection: Influence of Total PSA, Prostate Volume, and Age,” Urology, Vol. 48, No. 6, pp. 55–61, 1996.

    Article  Google Scholar 

  6. Silletti, J. P., Gordon, G. J., Bueno, R., Jakitsch, M., and Loughlin, K. R., “Prostate Biopsy: Past, Present, and Future,” Urology, Vol. 69, No. 3, pp. 413–416, 2007.

    Article  Google Scholar 

  7. Mettlin, C., Lee, F., Drago, J., and Murphy, G. P., “The American Cancer Society National Prostate Cancer Detection Project. Findings on the Detection of Early Prostate Cancer in 2425 Men,” Cancer, Vol. 67, No. 12, pp. 2949–2958, 1991.

    Article  Google Scholar 

  8. Bozeman, C. B., Carver, B. S., Caldito, G., Venable, D. D., and Eastham, J. A., “Prostate Cancer in Patients with an Abnormal Digital Rectal Examination and Serum Prostate-Specific Antigen Less than 4.0 ng/mL,” Urology, Vol. 66, No. 4, pp. 803–807, 2005.

    Article  Google Scholar 

  9. Pallwein, L., Mitterberger, M., Struve, P., Horninger, W., Aigner, F., and et al., “Comparison of Sonoelastography Guided Biopsy with Systematic Biopsy: Impact on Prostate Cancer Detection,” European Radiology, Vol. 17, No. 9, pp. 2278–2285, 2007.

    Article  Google Scholar 

  10. Fujita, K., Landis, P., Mcneil, B. K., and Pavlovich, C. P., “Serial Prostate Biopsies are Associated with an Increased Risk of Erectile Dysfunction in Men with Prostate Cancer on Active Surveillance,” The Journal of Urology, Vol. 182, No. 6, pp. 2664–2669, 2009.

    Article  Google Scholar 

  11. Schröder, F. H., Kruger, A. B., Rietbergen, J., Kranse, R., van der Maas, P., and et al., “Evaluation of the Digital Rectal Examination as a Screening Test for Prostate Cancer,” Journal of the National Cancer Institute, Vol. 90, No. 23, pp. 1817–1823, 1998.

    Article  Google Scholar 

  12. Gosselaar, C., Roobol, M. J., Roemeling, S., van der Kwast, T. H., and Schröder, F. H., “Screening for Prostate Cancer at Low PSA Range: the Impact of Digital Rectal Examination on Tumor Incidence and Tumor Characteristics,” The Prostate, Vol. 67, No. 2, pp. 154–161, 2007.

    Article  Google Scholar 

  13. Catalona, W., Richie, J., Ahmann, F., Hudson, M., Scardino, P., and et al., “Comparison of Digital Rectal Examination and Serum Prostate Specific Antigen in the Early Detection of Prostate Cancer: Results of a Multicenter Clinical Trial of 6,630 Men,” The Journal of Urology, Vol. 151, No. 5, pp. 1283–1290, 1994.

    Google Scholar 

  14. Smith, D. S., Catalona, W. J., and Herschman, J. D., “Longitudinal Screening for Prostate Cancer with Prostate-Specific Antigen,” JAMA: the Journal of the American Medical Association, Vol. 276, No. 16, pp. 1309–1315, 1996.

    Article  Google Scholar 

  15. Lederman, S. J. and Klatzky, R. L., “Sensing and Displaying Spatially Distributed Fingertip Forces in Haptic Interfaces for Teleoperator and Virtual Environment Systems,” Presence: Teleoperators and Virtual Environments, Vol. 8, No. 1, pp. 86–103, 1999.

    Article  Google Scholar 

  16. Gwilliam, J. C., Pezzementi, Z., Jantho, E., Okamura, A. M., and Hsiao, S., “Human vs. Robotic Tactile Sensing: Detecting Lumps in Soft Tissue,” Proc. of IEEE Haptics Symposium, pp. 21–28, 2010.

    Google Scholar 

  17. Smith, D. S. and Catalona, W. J., “Interexaminer Variability of Digital Rectal Examination in Detecting Prostate Cancer,” Urology, Vol. 45, No. 1, pp. 70–74, 1995.

    Article  Google Scholar 

  18. Dario, P. and Bergamasco, M., “An Advanced Robot System for Automated Diagnostic Tasks Through Palpation,” Proc. of IEEE Transaction on Biomedical Engineering, Vol. 35, No. 2, pp. 118–126, 1988.

    Article  Google Scholar 

  19. Bicchi, A., Canepa, G., De Rossi, D., Iacconi, P., and Scillingo, E. P., “A Sensor-Based Minimally Invasive Surgery Tool for Detecting Tissue Elastic Properties,” Proc. of IEEE International Conference on Robotics and Automation, Vol. 1, pp. 884–888, 1996.

    Google Scholar 

  20. Scilingo, E., Rossi, D., Bicchi, A., and Iaccone, P., “Haptic Display for Replication of Rheological Behavior of Surgical Tissues: Modelling, Control and Experiments,” Proc. of 6th Haptic Interfaces for Virtual Environment and Teleoperator Systems Symposium, pp. 173–176, 1997.

    Google Scholar 

  21. Yan, J., Scott, P. K., and Fearing, R. S., “Inclusion Probing: Signal Detection and Haptic Playback of 2D FEM and Experimental Data,” Proc. of IMECE, Vol. 67, pp. 203–210, 1999.

    Google Scholar 

  22. Chonan, S., Jiang, Z. W., Tanaka, M., Kato, T., Kamei, M., and Tanahashi, Y., “Development of a Palpation Sensor for Detection of Prostate Cancer and Hypertrophy (Optimum Structural Design of Sensor),” International Journal of Applied Electromagnetics and Mechanics, Vol. 9, No. 1, pp. 25–38, 1998.

    Google Scholar 

  23. Tanaka, M., Kamei, M., Furubayashi, M., Jiang, Z., Tanahashi, K., and Chonan, S., “Development of a Palpation Sensor for Detecting Prostate Cancer and Hypertrophy (Signal Processing on Clinical Data),” Transactions on the Japan Society of Mechanical Engineers, Vol. 65, pp. 3296–3301, 1999.

    Google Scholar 

  24. Tanaka, M., Furubayashi, M., Tanahashi, Y., and Chonan, S., “Development of an Active Palpation Sensor for Detection Prostatic Cancer and Hypertrophy,” Smart Materials and Structures, Vol. 9, No. 6, pp. 878–884, 2000.

    Article  Google Scholar 

  25. Liu, H., Noonan, D. P., Althoefer, K., and Seneviratne, L. D., “Rolling Mechanical Imaging: A Novel Approach for Soft Tissue Modelling and Identification during Minimally Invasive Surgery,” Proc. of IEEE International Conference on Robotics and Automation, pp. 845–850, 2008.

    Google Scholar 

  26. Liu, H., Noonan, D. P., Challacombe, B. J., Dasgupta, P., Seneviratne, L. D., and Althoefer, K., “Rolling Mechanical Imaging for Tissue Abnormality Localization During Minimally Invasive Surgery,” Proc. of IEEE Transactions on Biomedical Engineering, Vol. 57, No. 2, pp. 404–414, 2010.

    Article  Google Scholar 

  27. Sangpradit, K., Liu, H., Seneviratne, L.D., and Althoefer, K., “Tissue Identification using Inverse Finite Element Analysis of Rolling Indentation,” Proc. of IEEE international Conference on Robotics and Automation, pp. 1250–1255, 2009.

    Google Scholar 

  28. Sangpradit, K., Liu, H., Dasgupta, P., Althoefer, K., and Seneviratne, L. D., “Finite-Element Modeling of Soft Tissue Rolling Indentation,” Proc. of IEEE Transactions on Biomedical Engineering, Vol. 58, No. 12, pp. 3319–3327, 2011.

    Article  Google Scholar 

  29. Ahn, M., Kim, J., Ian, L., Rha, K. H., and Kim, H. J., “Mechanical Property Characterization of Prostate Cancer using a Minimally Motorized Indenter in an Ex vivo Indentation Experiment,” Urology, Vol. 76, No. 4, pp. 1007–1011, 2010.

    Article  Google Scholar 

  30. Ahn, B., Lorenzo, E. I., Rha, K. H., Kim, H. J., and Kim, J., “Robotic Palpation-Based Mechanical Property Mapping for Diagnosis of Prostate Cancer,” Journal of Endourology, Vol. 25, No. 5, pp. 851–857, 2011.

    Article  Google Scholar 

  31. Goodwin, A. W., John, K. T., and Marceglia, A. H., “Tactile Discrimination of Curvature by Humans using only Cutaneous Information from the Fingerpads,” Experimental Brain Research, Vol. 86, No. 3, pp. 663–672, 1991.

    Article  Google Scholar 

  32. Goodwin, A., Macefield, V., and Bisley, J., “Encoding of Object Curvature by Tactile Afferents from Human Fingers,” Journal of Neuro-physiology, Vol. 78, No. 6, pp. 2881–2888, 1997.

    Google Scholar 

  33. Srinivasan, M., Lamotte, R, “Tactual Discrimination of Softness,” Journal of Neuro-physiology, Vol. 73, No. 1, pp. 88–101, 1995.

    Google Scholar 

  34. Ahn, B., Kim, Y., Oh, C., and Kim, J., “Robotic Palpation and Mechanical Property Characterization for Abnormal Tissue Localization,” Medical & Biological Engineering & Computing, Vol. 50, No. 9, pp. 961–971, 2012.

    Article  Google Scholar 

  35. Schwenninger, D., Schumann, S., and Guttmann, J., “In vivo Characterization of Mechanical Tissue Properties of Internal Organs using Endoscopic Microscopy and Inverse Finite Element Analysis,” Journal of biomechanics, Vol. 44, No. 3, pp. 487–493, 2011.

    Article  Google Scholar 

  36. Choi, H. W. and Kim, Y. E., “Contribution of Paraspinal Muscle and Passive Elements of the Spine to the Mechanical Stability of the Lumbar Spine,” Int. J. Precis. Eng. Manuf., Vol. 13, No. 6, pp. 993–1002, 2012.

    Article  MathSciNet  Google Scholar 

  37. Kim, Y., Ahn, B., Lee, J. W., Rha, K. H., and Kim, J., “Local Property Characterization of Prostate Glands using Inhomogeneous Modeling Based on Tumor Volume and Location Analysis,” Medical & Biological engineering & Computing, Vol. 51, No. 1–2, pp. 197–205, 2013.

    Article  Google Scholar 

  38. Salvazyan, A., “Computerized Palpation is More Sensitive than Human Finger,” Proc. of the 12th International Symposium on Biomedical Measurements and Instrumentation, pp. 523–524, 1998.

    Google Scholar 

  39. Radmacher, M., “Measuring the Elastic Properties of Biological Samples with the AFM,” Proc. of IEEE Engineering in Medicine and Biology Magazine, Vol. 16, No. 2, pp. 47–57, 1997.

    Article  Google Scholar 

  40. Bloom, H. S., Criswell, E. L., Pennypacker, H. S., Catania, A. C., and Adams, C. K., “Major Stimulus Dimensions Determining Detection of Simulated Breast Lesions,” Perception & Psychophysics, Vol. 32, No. 3, pp. 251–260, 1982.

    Article  Google Scholar 

  41. Galosi, A. B., Montironi, R., Fabiani, A., Lacetera, V., Gallé, G., and Muzzonigro, G., “Cystic Lesions of the Prostate Gland: An Ultrasound Classification with Pathological Correlation,” The Journal of Urology, Vol. 181, No. 2, pp. 647–657, 2009.

    Article  Google Scholar 

  42. Evans, A., Whelehan, P., Thomson, K., McLean, D., Brauer, K., and et al., “Quantitative Shear Wave Ultrasound Elastography: Initial Experience in Solid Breast Masses,” Breast Cancer Research, Vol. 12, No. 6, pp. 1–11, 2010.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Mechanical Engineering, KAIST, 291 Daehak-ro, Yuseong-gu, Daejeon, Korea, 305-701

    Yeongjin Kim, Youngjin Na & Jung Kim

  2. The Simulation Group, Center for Integration of Medicine and Innovative Technology, Department of Radiology, Harvard Medical School, Cambridge, USA

    Bummo Ahn

  3. Department of Urology, Yonsei University College of Medicine, Urological Science Institute, Seoul, Korea

    Taeyoung Shin & Koonho Rha

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  1. Yeongjin Kim
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Correspondence to Jung Kim.

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Kim, Y., Ahn, B., Na, Y. et al. Digital rectal examination in a simulated environment using sweeping palpation and mechanical localization. Int. J. Precis. Eng. Manuf. 15, 169–175 (2014). https://doi.org/10.1007/s12541-013-0321-6

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  • DOI: https://doi.org/10.1007/s12541-013-0321-6

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