Hannes Cash

• Associate Professor, M.D.
• Professor (Associate) at Otto-von-Guericke University Magdeburg

To evaluate the performance of real-time MRI/ultrasound (MRI/US) fusion-guided targeted biopsy (TB) in men with primary and repeat biopsies and correlate the prostate cancer detection rate (CDR) with the PI-RADS score. Analysis included 408 consecutive men with primary and prior negative biopsies who underwent TB and 10-core random biopsy (RB) betw...

Objective To examine the value of additional transrectal ultrasonography (TRUS)‐guided random biopsy (RB) in patients with negative magnetic resonance imaging (MRI)/ultrasonography (US) fusion‐guided targeted biopsy (TB) and to identify possible reasons for TB failure. Patients and Methods We conducted a subgroup analysis of 61 men with prostate c...

Objective To examine the performance of a primary MRI/ultrasound fusion guided targeted biopsy (TB) and in combination with an added systematic biopsy (SB). Patients and methods Analysis of 318 consecutive biopsy naïve men with suspicious mpMRI (PI‐RADS score ≥3) undergoing transrectal TB and 10‐core systematic biopsy (SB) between January 2012 and...

Purpose: The second version of the Prostate Imaging Reporting and Data System (PI-RADSv2) was introduced in 2015 to standardize the interpretation and reporting of multiparametric prostate magnetic resonance imaging (mpMRI). Recently, low cancer detection rates (CDR) for PI-RADSv2 category 4 lesions were reported. Therefore the aim of the study wa...

Background Although multiparametric magnetic resonance imaging (mpMRI) revolutionized the implementation of prostate biopsies, a considerable amount of clinically significant prostate cancer (csPCa) is missed when performing mpMRI-targeted biopsies only. Microultrasound (micro-US) is a new modality that allows real-time targeting of suspicious regi...

Importance High-resolution microultrasonography-guided biopsy is an alternative to MRI fusion-guided biopsy for prostate cancer diagnosis. Objective To compare microultrasonography-guided and MRI fusion-guided biopsy. Design, Setting, and Participants A multicenter, international, open-label, randomized, noninferiority trial of biopsy-naive men f...

Background: The diagnostic approach to prostate cancer (PCa) has evolved from sys-tematic biopsies to imaging-guided strategies that improve detection of clinically sig-nificant PCa (csPCa) while reducing overdiagnosis. Multiparametric MRI (mpMRI) has emerged as the gold standard for pre-biopsy evaluation, while micro-ultrasound (Mi-croUS) offers a...

Importance The magnetic resonance imaging (MRI) pathway for diagnosing clinically significant prostate cancer (csPCa; defined as International Society of Urological Pathology grade group ≥2) uses multiparametric MRI (mpMRI) for prostate biopsy (PB) decision-making. However, the intermediate impact on patient outcomes in men with negative MRI result...

Purpose: Blunt abdominopelvic trauma frequently results in injuries to the urinary organs, especially in polytrauma. The urotrauma is rarely an acute life-threatening event; however, it may lead to severe complications. Methods: This review addresses the under-representation of urological trauma management in interdisciplinary medical training and...

Background Three primary strategies for MRI-targeted biopsies (TB) are available: Cognitive TB (COG-TB), MRI-US Fusion TB (FUS-TB), and In Bore TB (IB-TB). Despite nearly a decade of practice, a consensus on the preferred approach is lacking, with previous studies showing comparable PCa detection rates among the three methods. Methods We conducted...

To develop and test zone-specific prostate-specific antigen density (sPSAD) combined with PI-RADS to guide prostate biopsy decision strategies (BDS). This retrospective study included consecutive patients, who underwent prostate MRI and biopsy (01/2012–10/2018). The whole gland and transition zone (TZ) were segmented at MRI using a retrained deep l...

Purpose: To determine oncological and functional outcomes and side effects after focal therapy of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU). Methods: This retrospective single-center study included 57 consecutive patients with localised PCa. Aged 18–80 with ≤2 suspicious lesions on mpMRI (PIRADS ≥ 3), PSA of ≤15 ng/mL, and...

Background High variability in prostate MRI quality might reduce accuracy in prostate cancer detection. Purpose To prospectively evaluate the quality of MRI scanners taking part in the quality control phase of the global PRIME (Prostate Imaging Using MRI ± Contrast Enhancement) trial using the Prostate Imaging Quality (PI-QUAL) standardized scoring...

Recently, researchers have proposed perilesional sampling during prostate biopsies to avoid systematic biopsies of patients at risk of prostate cancer. The aim of our study is to evaluate the role of perilesional sampling to avoid systematic biopsies of patients undergoing fusion biopsies. A prospective cohort of patients undergoing transrectal MRI...

Background: In the context of blunt abdominal trauma, injuries to the urinary tracts often occur, especially in polytrauma patients. Urotrauma is rarely immediately life-threatening but can lead to serious complications and chronic functional limitations during treatment. Therefore early urological involvement is crucial for adequate interdiscipli...

Background Clinically significant prostate cancer (PCa) diagnosis at MRI requires accurate and efficient radiologic interpretation. Although artificial intelligence may assist in this task, lack of transparency has limited clinical translation. Purpose To develop an explainable artificial intelligence (XAI) model for clinically significant PCa diag...

Introduction: In this study, we sought to investigate the impact of 5-alpha reductase inhibitors (5-ARI) on the perioperative and functional outcomes of 180-Watt XPS GreenLight photovaporization of the prostate (PVP) using a large international database. Materials and methods: Data were obtained from the Global GreenLight Group (GGG) database, w...

Primary bladder neck obstruction (PBNO) is a dysfunction of the bladder neck (BN) in which the collum vesicae is narrow or fails to open adequately during voiding, resulting in a bladder outlet obstruction. PBNO causes storage or voiding LUTS often years before a correct diagnosis of PBNO is made. These patients have often been seen by many physici...

Introduction The present study analyzes the largest international GreenLight database, the Global GreenLight Group (GGG), to evaluate the functional and safety profile of GreenLight photoselective vaporization of the prostate (PVP) in octogenarians. Methods The GGG is a database comprised of patients that underwent GreenLight PVP from 2011 to 2019...

IntroductionGreenLight photoselective vaporization of the prostate (PVP) has gained widespread adoption as an option to traditional transurethral resection of the prostate. Prior reports expressed concern with the use of PVP in large prostates. The aim of this study was to investigate the adjusted outcomes of GreenLight PVP in men with large (≥ 80...

Background Magnetic resonance imaging (MRI) is used to detect the prostate index lesion before targeted biopsy. However, the number of biopsy cores that should be obtained from the index lesion is unclear. The aim of this study is to analyze how many MRI-targeted biopsy cores are needed to establish the most relevant histopathologic diagnosis of th...

Magnetic resonance imaging/Ultrasound (MRI/US) fusion targeted biopsy (TB) in combination with a systematic biopsy (SB) improves cancer detection but limited data is available how to manage patients with a Prostate Imaging-Reporting and Data System (PI-RADS) ≥ 4 lesion and a negative biopsy. We evaluate the real-world management and the rate of cli...

Purpose To evaluate the additional value of systematic biopsies (SB) when performing transperineal MRI/TRUS fusion biopsies (MRI/TRUS TPBx) with needle tracking. Methods From January 2019 to March 2021 969 Patients after a MRI/TRUS TPBx were evaluated separately for target biopsies (TB) and systematic biopsies regarding PCa detection and PCa risk...

Purpose We sought to characterize the adjusted outcomes of GreenLight photoselective vaporization of the prostate (PVP) in high-medical-risk (HMR) patients using data from the largest international database. Methods Data were obtained from the Global GreenLight Group (GGG) database which pools data of eight high-volume, experienced surgeons, from...

Purpose To evaluate changes in global perioperative data of GreenLight-XPS 180-Watt photo-selective vaporization of the prostate (GL-XPS) of the Global Greenlight Group (GGG) database. Methods 3441 men, who underwent GL-XPS for symptomatic BPH between 2011 and 2019 at seven high volume international centers, were included. Primary outcome measurem...

Purpose To analyze possible differences in the inter-reader variability between PI-RADS version 2 (v2) and version 2.1 (v2.1) for the classification of prostate lesions using multiparametric MRI (mpMRI) of the prostate. Methods In this retrospective and randomized study, 239 annotated and histopathologically correlated prostate lesions (104 positiv...

Quantitative ultrasound (QUS) assessment of osteoarthritis (OA) using high-frequency, research-grade single-element ultrasound systems has been reported. The objective of this ex vivo study was to assess the performance of QUS in detecting early OA using a high-frequency linear array transducer. Osteochondral plugs (n = 26) of human articular carti...

Objective Micro-ultrasound is an imaging modality used to visualize and target prostate cancer during transrectal or transperineal biopsy. We evaluated the effectiveness of a micro-ultrasound training program and estimated the learning curve for prostate biopsy. Methods A training program registry was assessed for the rate of clinically significant...

Background Although multiparametric magnetic resonance imaging (mpMRI) is recommended for primary risk stratification and follow-up in Active Surveillance (AS), it is not part of common AS inclusion criteria. The objective was to compare AS eligibility by systematic biopsy (SB) and combined MRI-targeted (MRI-TB) and SB within real-world data using...

Background: Focal therapy (FT) is an option to treat localized prostate cancer (PCa) and preserve healthy prostate tissue in order to reduce known side effects from primary whole-gland treatment. The available FT modalities are manifold. Until now, national and international PCa guidelines have been cautious to propose recommendations regarding FT...

Introduction Greenlight photo-selective vaporization of the prostate (GL-PVP) has gained international acceptance as a safe and effective alternative procedure for the treatment of benign prostatic hyperplasia (BPH), especially in anticoagulated men. This descriptive analysis aims to characterize the current state of GL-PVP, pooling data from inter...

Objective To compare the efficacy of multiparametric magnetic resonance imaging (mpMRI)‐directed and micro‐ultrasonography (micro‐US)‐directed biopsy for detecting clinically significant (Grade Group >1) prostate cancer (csPCa). Materials and Methods A total of 203 patients were prospectively enrolled at three institutions across Germany and Austr...

Background Micro-ultrasound (microUS) is a novel ultrasound-based imaging modality which has demonstrated the ability to visualize prostate cancer. Multiparametric MRI/ultrasound (mpMRI/US) fusion has recognized advantages for the performance of prostate biopsy, however, it encompasses additional cost, time and technical expertise to performing pro...

Objectives Previous analyses of the impact of median lobe presence on Greenlight photoselective vaporization of the prostate (PVP) outcomes were limited by their small sample size and the ability to adjust for important confounders. As such, we sought to investigate the impact of prostate median lobe presence on the operative outcomes of 180 W XPS...

PurposeThe aim of this study was to assess the post biopsy infection rate, feasibility and prostate cancer (PCa) detection rate (CDR) by performing transperineal MRI-TRUS fusion biopsy of the prostate (TPBx) under local anesthesia (LA) without antibiotic prophylaxis (AP).Methods We prospectively screened 766 men with suspicious lesions on mpMRI, an...

Purpose Due to the tissue preserving approach of focal therapy (FT), local cancer relapse can occur. Uncertainty exists regarding triggers and outcome of salvage strategies. Methods Patients with biopsy-proven prostate cancer (PCa) after FT for localized PCa from 2011 to 2020 at eight tertiary referral hospitals in Germany that underwent salvage r...

Purpose Focal segmental glomerulosclerosis (FSGS) is a common cause for end-stage renal disease that can recur in the graft after kidney transplantation. The incidence of FSGS recurrence is reported in up to 47% of patients, predisposing those to possible poorer transplantation outcomes. Hence, we examined the incidence of FSGS recurrence and the e...

Purpose: In the current review, we will discuss the state of the literature of vaporization of the prostate for the treatment of benign prostatic enlargement (BPE). We discuss two methods of vaporization of the prostate: Transurethral Vaporization of the Prostate (TUVP) and Greenlight Photo-selective Vaporization of the Prostate (PVP). Methods:...

Background: To develop an international, multi-site nomogram for side-specific prediction of extraprostatic extension (EPE) of prostate cancer based on clinical, biopsy, and magnetic resonance imaging- (MRI) derived data. Methods: Ten institutions from the USA and Europe contributed clinical and side-specific biopsy and MRI variables of consecut...

Background Focal therapy (FT) with its favorable side-effect profile represents an option between active surveillance and traditional whole-gland treatment in localized prostate cancer (PCa). Consensus statements recommend eligibility criteria based on magnetic resonance imaging (MRI)-targeted and systematic combination biopsy. Objective To estima...

The purpose of this study is to compare diagnostic performance of Prostate Imaging Reporting and Data System (PI-RADS) version (v) 2.1 and 2.0 for detection of Gleason Score (GS) ≥ 7 prostate cancer on MRI. Three experienced radiologists provided PI-RADS v2.0 scores and at least 12 months later v2.1 scores on lesions in 333 prostate MRI examination...

Purpose: Focal therapy (FT) became a frequently discussed treatment strategy of localized prostate cancer (PCa), but the acceptance and evaluation of FT by practicing urologists is still unclear. Methods: A 25-item anonymized online questionnaire (SurveyMonkey®) was compiled by the German Society of Residents in Urology (GesRU) Academics prostat...

Purpose An expansion of selection criteria for deceased organ transplantation already exists to manage the current donor shortage. Comparable evaluation of risk factors for living donors should be investigated to improve this issue. Patients and Methods Our retrospective single-centre study analysed 158 patients with living kidney transplants perf...

Introduction: High-resolution micro-ultrasound has the capability of imaging prostate cancer based on detecting alterations in ductal anatomy, analogous to multiparametric magnetic resonance imaging (mpMRI). This technology has the potential advantages of relatively low cost, simplicity, and accessibility compared to mpMRI. This multicenter, prosp...

Introduction: In living donor transplantation choosing the right donor and donor side for laparoscopic donor nephrectomy is a challenging task in clinical practice. Knowledge about anomalies in renal blood supply are crucial to evaluate the feasibility of the operative procedure. Few data so far exist whether the existence of a retroaortic left re...

Purpose To evaluate if size-based cut-offs based on MR imaging can successfully assess clinically significant prostate cancer (csPCA). The goal was to improve the currently applied size-based differentiation criterion in PI-RADS. Methods and materials MRIs of 293 patients who had undergone 3 T MR imaging with subsequent confirmation of prostate ca...

Objectives To assess the discriminatory power of lexicon terms used in PI-RADS version 2 to describe MRI features of prostate lesions.Methods Four hundred fifty-four patients were included in this retrospective, institutional review board–approved study. Patients received multiparametric (mp) MRI and subsequent prostate biopsy including MRI/transre...

296 Background: This study aims to compare the sensitivity, specificity, NPV and PPV of mpMRI with the novel high-resolution micro-ultrasound imaging modality. This approach offers the benefits of simplicity, a single intervention for imaging and biopsy, leveraging the low cost of ultrasound. Micro-ultrasound may be used to image suspicious lesions...

Purpose of review: In the setting of kidney transplantation, the ureter is a common source for complications. As a result, prevention of ureteral complications and their management is of crucial importance. In this context, the purpose of this review is to summarize recent literature on the ureter in the kidney transplant setting with a special fo...

Introduction: The use of GreenLight™ laser technology to remove the prostatic transitional zone (TZ) transurethrally has grown considerably in recent years, and with it an increase in the number of terms that are used to describe similar techniques. Varying terminology complicates literature analysis and publication, which can cause confusion when...

Introduction: Patients with consistent suspicion for prostate cancer (PCa) and multiple negative prebiopsies prior to multiparametric magnetic resonance imaging (mpMRI) are still frequently evaluated for an image-guided biopsy and are reported with heterogeneous detection rates. The inclusion of a systematic biopsy (SB) is also still recommended w...

For men experiencing lower urinary tract symptoms (LUTS) refractory to medical therapy, there have been numerous developments in the treatment options offered for benign prostatic hyperplasia (BPH) in the recent years. Transurethral resection of the prostate (TURP) has remained the reference standard for men with prostates sized 30 cc-80 cc, while...

The aim of this paper was to compare the perioperative and postoperative results of photoselective vaporization of the prostate with the GreenLight-XPS 180 Watt System (PVP) and transurethral resection of the prostate (TURP). This retrospective study included 140 men who underwent PVP and 114 men who underwent TURP for symptomatic benign prostate e...

Background Primary transrectal ultrasound random biopsies do not detect all prostate cancer foci, leading to the necessity of repeat biopsies if prostate cancer suspicion persists. Moreover, corresponding false negative rates and discrepancies between biopsy Gleason scores and final radical prostatectomy pathology must be considered. These challeng...

Purpose To evaluate the accuracy of clinical parameters and established pre‐treatment risk stratification systems for prostate cancer (PCa) in predicting PSMA‐positive metastases in men undergoing Ga‐68‐PSMA PET/CT as initial staging examination. Materials and Methods A retrospective analysis in 108 consecutive treatment‐naïve patients with biopsy...

Objective To investigate non‐inferiority of intermittent docetaxel compared to continuous docetaxel in patients with metastactic castration resistant prostate cancer (mCRPC). Patient and Methods The investigator initiated randomized phase III study included 187 chemotherapy‐naïve mCRPC patient who allocated to two treatment arms: intermittent doce...

Purpose: The study aimed to evaluate progression of GreenLight-XPS 180 W photoselective vaporization of the prostate (GL-XPS) with respect to effectiveness, efficacy, and safety over time at a tertiary referral high volume center. Methods: The retrospective study included 375 men who underwent GL-XPS for symptomatic benign prostate obstruction (...

Background: To explore the diagnostic benefit of an additional image fusion of the sagittal plane in addition to the standard axial image fusion, using a sensor-based MRI/US fusion platform. Methods: During July 2013 and September 2015, 251 patients with at least one suspicious lesion on mpMRI (rated by PI-RADS) were included into the analysis....

Introduction: The objective of this study was to evaluate changes of patient characteristics and surgical techniques in radical prostatectomy in Germany within the last decade. Methods: Data from 44 German prostate cancer centers were included in the study. Patients' characteristics (age, initial PSA value), surgical techniques (open vs. minimal...

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0042-119237

BACKGROUND Several systems for MRI/TRUS fusion-guided biopsy of the prostate are commercially available. Many studies have shown superiority of fusion systems for tumor detection and diagnostic quality compared to random biopsy. The benefit of fusion systems in focal therapy of prostate cancer (PC) is less clear. OBJECTIVES Critical considerations...

Prostate volume in multiparametric MRI (mpMRI) is of clinical importance. For 3-Tesla mpMRI without endorectal coil, there is no distinctive standard for volume calculation. We tested the accuracy of the ellipsoid formula with planimetric volume measurements as reference and investigated the correlation of gland volume and cancer detection rate on...

Objective: Evaluating the predictive factors that enable identifying men in which a sole MRI/ultrasound (MRI/US) fusion-guided targeted biopsy (TB) detects the maximal prostate cancer (PCa) risk group. Patients and methods: Retrospective analysis of 251 consecutive patients who received a sensor-based, real-time MRI/US TB in combination with a 1...

https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0042-111915?lang=de

Hintergrund: Nach Einführung der revidierten Version des PI-RADS Scoring Systems kann eine scorebedingte Varianz zwischen Version 1 und 2 vermutet werden. Ziel unserer Studie war ein Vergleich der PI-RADS Scores der Version 1 (V1) und der aktualisierten Version 2 (V2). Material und Methoden: 61 Patienten mit biop- siegesichertem Prostatakarzinom (P...

A randomized phase III study investigating the non-inferiority of an intermittent docetaxel compared to a continuous docetaxel treatment for patients with castration-resistant prostate cancer (CRPC). Methods: 187 patients were randomized to either an intermittent docetaxel treatment or to a continuous docetaxel treatment until discontinuation (doce...

Prostate cancer (PCa) is the most frequently diagnosed malignancy among men in Western Europe and the United States. Due to PSA-testing and early detection strategies, the proportion of men diagnosed with low risk disease according to the D´Amico criteria (PSA ≤ 10ng/ml, Gleason-Score ≤ 6, clinical stage ≤ T2a) has significantly increased from 27.5...

To analyze whether magnetic resonance imaging-ultrasonography (MRI-US) fusion-guided biopsy detects more and clinical significant prostate cancer (PCa) in comparison to conventional transrectal US-guided prostate biopsy (PBX) and to investigate if multiparametric (mp) US during MRI-US fusion can further characterize mpMRI-suspected lesions accordin...

Sertoli cell tumors are a rare malignancy which account for approximately 1.5 % of all testicular tumors. Although malignant Sertoli cell tumors are uncommon, they are associated with a poor prognosis. So far 36 cases of malignant courses of disease have been described. We present a patient with a lymphogenic metastasized Sertoli cell tumor, who 24...

Background: Magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided biopsy detects more prostate cancer (PCa) than transrectal US (TRUS)-guided biopsy in patients with an indication for prostate re-biopsy. The aim of this study was a) to compare the detection rates of MRI/US fusion-guided biopsy with conventional TRUS in a double centre coho...

Objective: We conducted this study to determine whether it is justifiable for transplant centers to reject cadaveric donor organs based on marginal organ quality. There is a growing discrepancy between the demand for renal transplants and the number of transplants conducted. For the many patients on the renal transplant waiting list, this translat...

Introduction: Bladder cancer (BC) represents a growing health care problem worldwide. In times of tight budgets and an aging society, new strategies for the transurethral treatment of BC are needed. Laser devices used for tumor vaporization and/or en bloc resection provide an alternative to parvenu strategies. Materials and methods: Medline/Coch...

Worldwide, approximately 330,000 new cases of bladder cancer (BC) are diagnosed each year and 130,000 people die annually of this disease. Median age at diagnosis is 70 years and men are at 3.8 times higher risk than women. In western countries, the lifetime risk of developing BC is 2.4 % and it is the fourth most common solid tumor in men. Exposur...

Objectives: To investigate pathological and oncological outcomes of obese patients who underwent robot-assisted radical prostatectomy (RARP) compared with laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (RRP) since limited comparative data exist with regard to oncological and survival outcomes. Methods: A total...

Introduction: Radical retropubic prostatectomy (RRP) is associated with an increased risk of intraoperative blood loss and the necessity of transfusions. This prospective randomised clinical study evaluates the influence of thoracic epidural analgesia (TEA) on blood loss in RRP. Materials and methods: 235 patients were randomised: TEA in group 1...

Background: According to the guidelines of the European Association of Urology (EAU) on prostate cancer (PCa) in 2013, patients with increasing prostate-specific antigen (PSA) levels, suspicious digital rectal examination (DRE) or high-grade prostatic intraepithelial neoplasia after negative prostate biopsy (PB) should undergo a repeat biopsy. Low...

Background Retroperitoneal fibrosis (RPF) is rare disease wich presents with bilateral hydronephrosis as the most common symptom. Objectives One of the aims in the treatment of retroperitoneal fibrosis (RPF) is to restore renal drainage and maintain renal function. We investigated the rate of ureteral stent-freedom after conservative and surgical t...

Introduction: In times of organ shortage more kidneys were transplanted in 'expanded criteria kidney' programs. This study examines the outcome of adult kidney recipients from pediatric donors. Materials and methods: This single-center retrospective analysis evaluated eight adult patients who received a kidney from a deceased pediatric donor (ag...