Ghulam Nabi - Academia.edu (original) (raw)

Papers by Ghulam Nabi

Research paper thumbnail of Laparoscopic nephrectomy for adult polycystic kidney disease (APKD): safety, feasibility and early outcomes

International Journal of Surgery, 2014

Research paper thumbnail of Predictive accuracy of boosted regression model in estimating risk of venous thromboembolism following minimally invasive radical surgery in pharmacological prophylaxis-naïve men with prostate cancer

World journal of surgical oncology, Feb 23, 2024

Background Venous thromboembolism (VTE) is a potentially life-threatening but preventable complic... more Background Venous thromboembolism (VTE) is a potentially life-threatening but preventable complication after urological surgery. Physicians are faced with the challenges of weighing the risks and benefits of thromboprophylaxis given scanty evidence for or against and practice variation worldwide. Objective The primary objective of the study was to explore the possibility of a risk-stratified approach for thromboembolism prophylaxis following radical prostatectomy. Design, setting, and participants A prospective database was accessed to cross-link venous thromboembolism events in 522 men who underwent minimally invasive prostatectomy between February 2010 and October 2021. A deterministic data linkage method was used to record events through electronic systems. Community Health Index (CHI) numbers were used to identify patients via electronic health records. Patient demographics and clinical characteristics such as age, comorbidities, Gleason staging, and readmission details accrued. Outcomes VTE within 90 days and development of a risk-stratified scoring system. All statistical analysis was performed using R-Statistical Software and the risk of VTE within 90 days of surgery was estimated via gradient-boosting decision trees (BRT) model. Results and limitations 1.1% (6/522) of patients developed deep vein thrombosis or pulmonary embolism within 3 months post-minimally invasive prostatectomy. Statistical analysis demonstrated a significant difference in the body mass index (p = 0.016), duration of hospital stay (p < 0.001), and number of readmissions (p = 0.036) between patients who developed VTE versus patients who did not develop VTE. BRT analysis found 8 variables that demonstrated relative importance in predicting VTE. The receiver operating curves (ROC) were constructed to assess the discrimination power of a new model. The model showed an AUC of 0.97 (95% confidence intervals [CI]: 0.945,0.999). For predicting VTE, a single-center study is a limitation.

Research paper thumbnail of Radiogenomics Reveals Correlation between Quantitative Texture Radiomic Features of Biparametric MRI and Hypoxia-Related Gene Expression in Men with Localised Prostate Cancer

Journal of Clinical Medicine

Objectives: To perform multiscale correlation analysis between quantitative texture feature pheno... more Objectives: To perform multiscale correlation analysis between quantitative texture feature phenotypes of pre-biopsy biparametric MRI (bpMRI) and targeted sequence-based RNA expression for hypoxia-related genes. Materials and Methods: Images from pre-biopsy 3T bpMRI scans in clinically localised PCa patients of various risk categories (n = 15) were used to extract textural features. The genomic landscape of hypoxia-related gene expression was obtained using post-radical prostatectomy tissue for targeted RNA expression profiling using the TempO-sequence method. The nonparametric Games Howell test was used to correlate the differential expression of the important hypoxia-related genes with 28 radiomic texture features. Then, cBioportal was accessed, and a gene-specific query was executed to extract the Oncoprint genomic output graph of the selected hypoxia-related genes from The Cancer Genome Atlas (TCGA). Based on each selected gene profile, correlation analysis using Pearson’s coeff...

Research paper thumbnail of Quantitative ultrasound shear wave elastography (USWE)-measured tissue stiffness correlates with PIRADS scoring of MRI and Gleason score on whole-mount histopathology of prostate cancer: implications for ultrasound image-guided targeting approach

Insights into Imaging, 2021

Objective To correlate quantitative tissue stiffness measurements obtained by transrectal ultraso... more Objective To correlate quantitative tissue stiffness measurements obtained by transrectal ultrasound shear wave elastography (USWE) with PI-RADS scoring of multiparametric magnetic imaging resonance (mpMRI) using Gleason scores of radical prostatectomy as a reference standard. Patients and methods 196 men with localised prostate cancer were prospectively recruited into the study and had quantitative prostate tissue stiffness measurements in kilopascals (kPa) using transrectal USWE prior to radical prostatectomy. PI-RADS scores of mpMRI were also obtained in all the men. Imaging and histopathology of radical prostatectomy specimen were oriented to each other using patient specific customised 3D moulds to guide histopathology grossing of radical prostatectomy specimens. All included patients had confirmed PCa on TRUS-guided biopsies, had both USWE and mpMRI imaging data, and underwent radical prostatectomy. Chi-square test with 95% confidence interval was used to assess the difference...

Research paper thumbnail of Diagnostic accuracy of image-guided biopsies in small (<4 cm) renal masses with implications for active surveillance: a systematic review of the evidence

The British journal of radiology, 2018

To determine the safety and diagnostic accuracy of renal tumour biopsies in a defined population ... more To determine the safety and diagnostic accuracy of renal tumour biopsies in a defined population of small renal masses (SRMs) only <4 cm using 3 × 2 table, intention to diagnose approach. 3 × 2 table approach examines indeterminate results as a separate category rather than pushing these through traditional 2 × 2 table (four-cell matrix) approach. A highly sensitive search was performed in the Cochrane Library, Database of Abstracts of Reviews of Effects; MEDLINE and MEDLINE in Process, EMBASE and conference proceedings (1966-2016) for the acquisition of data on the diagnostic accuracy and complications of RTB in patients with SRM <4 cm. Methodological quality and risk of bias was assessed using QUADAS-2. Test characteristics were calculated using conventional 2 × 2 contingency table analysis excluding non-diagnostic biopsies, and an intention-to-diagnose approach with a 3 × 2 table for pooled estimates of the sensitivity and specificity. A total of 20 studies were included wi...

Research paper thumbnail of A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers

European Journal of Oncology Nursing, 2018

A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention fo... more A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. 2018 PATERSON, C., PRIMEAU, C. and NABI, G. 2018. A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. European journal of oncology nursing [online], 37, pages 65-73.

Research paper thumbnail of Periprostatic Fat Adipokines Expression Correlated with Prostate Cancer Aggressiveness in Men Undergoing Radical Prostatectomy for Clinically Localised Disease

BJU international, Jan 3, 2018

To investigate relationship between periprostatic adipose tissue (PPAT) adipokines expression and... more To investigate relationship between periprostatic adipose tissue (PPAT) adipokines expression and PCa aggressiveness using both pathological features of radical prostatectomy (RP) and multiparametric MRI parameters. Sixty-nine men were recruited to assess immunohistochemical expression of TNFα- and VEGF of periprostatic fat of radical prostate specimens. Percent immunopositivity was quantified on scanned slides using Aperio Positive Pixel Count algorithm for PPAT TNFα, VEGF and androgen receptors. Periprostatic fat volume (PFV) was segmented on contiguous T -weighted axial MRI slices from the level of the prostate base to apex. PFV was normalised to prostate volume (PV) to account for variations in PV (NPFV=PFV/PV). MRI quantitative values (K , K and ADC) were measured from PCa primary lesion using OleaSphere software. Patients were stratified into three groups according to RP GS: ≤6, 7(3+4) and 7(4+3) or more. The mean rank of VEGF and TNFα were significantly different between the ...

Research paper thumbnail of Change in Nephrometry Scoring in Small Renal Masses (<4 cm) on Active Surveillance: Preliminary Observations From Tayside Active Surveillance Cohort (TASC) Study

Academic radiology, Jan 6, 2018

Prediction of growth, in particular knowing the possibility of aggressive cancer in small renal m... more Prediction of growth, in particular knowing the possibility of aggressive cancer in small renal masses on active surveillance, remains poorly understood. The study was designed to determine whether serial nephrometry score measurements could predict possibility of aggressive malignancy (grade of cancer) in patients with small renal masses opting for active surveillance initially. One hundred sixteen patients between January 2000 and December 2016 undergoing partial nephrectomy were recruited. Out of these, 97 were analyzed using different nephrometry scoring systems. Measurement of nephrometry scores (Radius of tumors, Exo/Endophytic; Nearness of tumors to the collecting system or sinus; Anterior/posterior; Location in relation to polar lines, Preoperative Aspects and Dimensions Used for Anatomical, Centrality Index) was performed by two researchers. Among the patients opting for partial nephrectomy, 40 were on active surveillance for at least 12 months (mean 32; 12-60 months) befor...

Research paper thumbnail of Microscale characterization of prostate biopsies tissues using optical coherence elastography and second harmonic generation imaging

Laboratory investigation; a journal of technical methods and pathology, Jan 18, 2017

Photonics, especially optical coherence elastography (OCE) and second harmonic generation (SHG) i... more Photonics, especially optical coherence elastography (OCE) and second harmonic generation (SHG) imaging are novel high-resolution imaging modalities for characterization of biological tissues. Following our preliminary experience, we hypothesized that OCE and SHG imaging would delineate the microstructure of prostate tissue and aid in distinguishing cancer from the normal benign prostatic tissue. Furthermore, these approaches may assist in characterization of the grade of cancer, as well. In this study, we confirmed a high diagnostic accuracy of OCE and SHG imaging in the detection and characterization of prostate cancer for a large set of biopsy tissues obtained from men suspected to have prostate cancer using transrectal ultrasound (TRUS). The two techniques and methods described here are complementary, one depicts the stiffness of tissues and the other illustrates the orientation of collagen structure around the cancerous lesions. The results showed that stiffness of cancer tissu...

Research paper thumbnail of Tumour suppressor gene (CDKNA2) status on chromosome 9p in resected renal tissue improves prognosis of localised kidney cancer

Oncotarget, Jan 22, 2016

Genetic alterations on chromosome 9p, including inactivation of the tumour suppressor gene, CDKN2... more Genetic alterations on chromosome 9p, including inactivation of the tumour suppressor gene, CDKN2A, result in cellular proliferation and growth of tumours. Our aim was to use microsatellite analysis and fluorescence in situ hybridization (FISH) to characterise the architecture of this region. Seventy-five out of 77 clear cell renal cell cancers (tumour/normal pairs) were interpretable for LOH analysis on chromosome 9p (two tumours were excluded, as all five primers were uninformative). Twenty out of 75 (26.6%) tumours showed LOH in at least one of the five primers employed. Most allelic deletions were detected, telomeric to the CDKN2A region at D9S916, with 11 out of 52 informative tumours (21%) displaying LOH. The LOH in the coding region of CDKN2A, at D9S974 and D9S942, was associated with a higher pT-stage (p = 0.004) and metastasis (p = 0.006, both markers). The rate of chromosome 9p deletion in ccRCC was 44% (35/80 cases) according to FISH. Somatic copy number loss of chromosom...

Research paper thumbnail of Microsatellite alteration and immunohistochemical expression profile of chromosome 9p21 in patients with sporadic renal cell carcinoma following surgical resection

BMC cancer, Jul 27, 2016

Long-term prognostic significance of loss of heterozygosity on chromosome 9p21 for localized rena... more Long-term prognostic significance of loss of heterozygosity on chromosome 9p21 for localized renal cell carcinoma following surgery remains unreported. The study assessed the frequency of deletions of different loci of chromosome 9p along with immunohistochemical profile of proteins in surgically resected renal cancer tissue and correlated this with long-term outcomes. DNA was extracted from renal tumours and corresponding normal kidney tissues in prospectively collected samples of 108 patients who underwent surgical resection for clinically localized disease between January 2001 and December 2005, providing a minimum of 9 years follow-up for each participant. After checking quality of DNA, amplified by PCR, loss of heterozygosity (LOH) on chromosome 9p was assessed using 6 microsatellite markers in 77 clear cell carcinoma. Only 5 of the markers showed LOH (D9S1814, D9S916, D9S974, D9S942, and D9S171). Protein expression of p15(INK4b), p16(INK4a), p14(ARF), CAIX, and adipose related...

Research paper thumbnail of Significance of chromosome 9p status in renal cell carcinoma: a systematic review and quality of the reported studies

BioMed research international, 2014

Defining the prognosis of renal cell carcinoma (RCC) using genetic tests is an evolving area. The... more Defining the prognosis of renal cell carcinoma (RCC) using genetic tests is an evolving area. The prognostic significance of 9p status in RCC, although described in the literature, remains underutilised in clinical practice. The study explored the causes of this translational gap. A systematic review on the significance of 9p status in RCC was performed to assess its clinical applicability and impact on clinical decision-making. Medline, Embase, and other electronic searches were made for studies reporting on 9p status in RCC. We collected data on: genetic techniques, pathological parameters, clinical outcomes, and completeness of follow-up assessment. Eleven studies reporting on 1,431 patients using different genetic techniques were included. The most commonly used genetic technique for the assessment of 9p status in RCC was fluorescence in situ hybridization. Combined genomic hybridisation (CGH), microsatellite analysis, karyotyping, and sequencing were other reported techniques. ...

Research paper thumbnail of Carcinoma In Situ Is Significantly Underdetected by Prenephroureterectomy Ureteroscopy in the Management of Upper Tract Urothelial Cancers

BioMed Research International, 2015

Objective. Diagnostic reliability of prenephroureterectomy ureteroscopy (PNU) for the detection o... more Objective. Diagnostic reliability of prenephroureterectomy ureteroscopy (PNU) for the detection of upper tract carcinoma in situ (CIS) remains unproven in particular and underreported in general.Methods. Patients who underwent radical nephroureterectomy (RNU) in a large multicentre retrospective study for upper tract transitional cell carcinoma (UT-TCC) between January 2002 and December 2013 were identified from our hospitals databases. PNU appearances, stage, and grade of ureteroscopic biopsy were compared with final histology results of RNU to assess the diagnostic reliability of PNU for carcinoma in situ (CIS).Results. Three hundred patients underwent RNU for UT-TCC. 106 (106/300; 35.3%) of the cohort had PNU using white light with biopsies taken in most (92/106; 86.7%). Postnephroureterectomy histology of the cohort showed CIS in 65 (65/300; 21.6%) patients. Thirty nine of patients with CIS (39/65; 60%) had prenephroureterectomy ureteroscopy biopsies. Out of ten patients with CI...

Research paper thumbnail of Comparative Assessment of Laparoscopic Single-Site Surgery Instruments to Conventional Laparoscopic in Laboratory Setting

Journal of Endourology, 2010

Introduction: Laparoendoscopic single-site surgery (LESS) represents the latest innovation in lap... more Introduction: Laparoendoscopic single-site surgery (LESS) represents the latest innovation in laparoscopic surgery. We compare in dry and animal laboratory the efficacy of recently introduced pre-bent instruments with conventional laparoscopic and flexible instruments in terms of time requirement, maneuvrability, and ease of handling. Materials and Methods: Participants of varying laparoscopic experience were included in the study and divided in groups according to their experience. The participants performed predetermined tasks in dry laboratory using all sets of instruments. An experienced laparoscopic surgeon performed 24 nephrectomies in 12 pigs using all sets of instruments. Single port was used for all instrument sets except for the conventional instruments, which were inserted through three ports. The time required for the performance of dry laboratory tasks and the porcine nephrectomies was recorded. Errors in the performance of dry laboratory tasks of each instrument type were also recorded. Results: Pre-bent instruments had a significant advantage over flexible instruments in terms of time requirement to accomplish tasks and procedures as well as maneuvrability. Flexible instruments were more time consuming in comparison to the conventional laparoscopic instruments during the performance of the tasks. There were no significant differences in the time required for the accomplishment of dry laboratory tasks or steps of nephrectomy using conventional instruments through appropriate number of ports in comparison to pre-bent instruments through single port. Discussion: Pre-bent instruments were less time consuming and with better maneuvrability in comparison to flexible instruments in experimental single-port access surgery. Further clinical investigations would elucidate the efficacy of pre-bent instruments.

Research paper thumbnail of Selective sampling using confocal Raman spectroscopy provides enhanced specificity for urinary bladder cancer diagnosis

Analytical and Bioanalytical Chemistry, 2012

Research paper thumbnail of Optical redox ratio and endogenous porphyrins in the detection of urinary bladder cancer: A patient biopsy analysis

Journal of biophotonics, Jan 7, 2016

Bladder cancer is among the most common cancers in the UK and conventional detection techniques s... more Bladder cancer is among the most common cancers in the UK and conventional detection techniques suffer from low sensitivity, low specificity, or both. Recent attempts to address the disparity have led to progress in the field of autofluorescence as a means to diagnose the disease with high efficiency, however there is still a lot not known about autofluorescence profiles in the disease. The multi-functional diagnostic system "LAKK-M" was used to assess autofluorescence profiles of healthy and cancerous bladder tissue to identify novel biomarkers of the disease. Statistically significant differences were observed in the optical redox ratio (a measure of tissue metabolic activity), the amplitude of endogenous porphyrins and the NADH/porphyrin ratio between tissue types. These findings could advance understanding of bladder cancer and aid in the development of new techniques for detection and surveillance.

Research paper thumbnail of Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease

Insights into Imaging

Objectives To compare the accuracy of pre-surgical prostate size measurements using mpMRI and USW... more Objectives To compare the accuracy of pre-surgical prostate size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology, and to assess whether size assessment varies between clinically significant and non-significant cancerous lesions including their locations in different zones of the prostate. Methods The study population included 202 men with clinically localised prostate cancer opting for radical surgery derived from two prospective studies. Protocol-based imaging data was used for measurement of size of prostate cancer in clinically localised disease using MRI (N = 106; USWE (N = 96). Forty-eight men overlapped between two studies and formed the validation cohort. The primary outcome of this study was to assess the accuracy of pre-surgical prostate cancerous size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology as a reference stan...

Research paper thumbnail of Pelvic Lipomatosis Presenting as Uraemic Encephalopathy

International Journal of Clinical Practice

Pelvic lipomatosis is a benign disorder of unknown aetiology, characterised by deposition of matu... more Pelvic lipomatosis is a benign disorder of unknown aetiology, characterised by deposition of mature fat in the pelvis. It has a variable natural history, manifesting either with symptoms attributable to the lower urinary tract or varying degrees of renal failure. Owing to the mild, non-specific initial symptoms and slow progression, presentation is delayed and patients are often lost to follow-up, only to present with advanced renal failure later on. We report a case of a young patient with pelvic lipomatosis who, after an initial diagnosis, was lost to follow-up for several years and then presented with uraemic encephalopathy. The case highlights the importance of regular follow-up and an early intervention before irreversible changes occur.

Research paper thumbnail of Evaluation of Lemon Varieties on Australian Bigarade Rootstock

An experiment “Evaluation of lemon varieties on Australian Bigarade rootstock in the climatic con... more An experiment “Evaluation of lemon varieties on Australian Bigarade rootstock in the climatic conditions of Malakand” was conducted at Subtropical Germplasm Unit Sherkhana Malakand during 2014. Four lemon varieties i.e., Mesero, Lisbon, Eureka and Foothill eureka were budded on Australian Bigarade (Citrus auriantium) rootstock in 2006. Experiment was laid out as single factor Randomized Complete Block Design. There were four replications per treatment (variety), each tree was considered as one replicate. The results revealed that Corona foothill Eureka gained significant vigorous tree growth 4.02 m taller and 4.38 m expanded canopy spread, while trunk circumference/girth was more in Lisbon (75.33 cm), followed by Corona Foothill Eureka (71.67 cm). Statistically, there were no differences in bloom time and the fruit set per twig. However, numbers of flowers per twig were significantly more in Lisbon (35.33) followed by Mesero (27). The highest fruits were set by Corona foothill Eurek...

Research paper thumbnail of Complex Renal Cysts (Bosniak ≥ IIF): Outcomes in a Population-Based Cohort Study

Cancers, 2020

There is emerging evidence to suggest that con-current medical conditions influence the outcome o... more There is emerging evidence to suggest that con-current medical conditions influence the outcome of cancers, irrespective of therapy offered. The prevalence and impact of co-morbidities on the survival outcome of complex renal cystic masses in not known. The objective was to study complex renal cysts (Bosniak ≥IIF ) and assess the overall and renal cancer-specific survival in a population-based database including impact of con-current morbidities. The Tayside Urological Cancer Network (TUCAN) database covering a stable population of more than 416,090 inhabitants in a defined geographical area identified 452 complex renal cysts in 415 patients between 2009 and 2019. Each patient was tracked and followed up using a unique identifier and deterministic linkage methodology. The last date of follow-up including cause of death was determined. Co-morbidities were recorded from primary care referrals. Renal cancer-specific mortality was 1.7% at a median follow-up of 76.0 months; however, over...

Research paper thumbnail of Laparoscopic nephrectomy for adult polycystic kidney disease (APKD): safety, feasibility and early outcomes

International Journal of Surgery, 2014

Research paper thumbnail of Predictive accuracy of boosted regression model in estimating risk of venous thromboembolism following minimally invasive radical surgery in pharmacological prophylaxis-naïve men with prostate cancer

World journal of surgical oncology, Feb 23, 2024

Background Venous thromboembolism (VTE) is a potentially life-threatening but preventable complic... more Background Venous thromboembolism (VTE) is a potentially life-threatening but preventable complication after urological surgery. Physicians are faced with the challenges of weighing the risks and benefits of thromboprophylaxis given scanty evidence for or against and practice variation worldwide. Objective The primary objective of the study was to explore the possibility of a risk-stratified approach for thromboembolism prophylaxis following radical prostatectomy. Design, setting, and participants A prospective database was accessed to cross-link venous thromboembolism events in 522 men who underwent minimally invasive prostatectomy between February 2010 and October 2021. A deterministic data linkage method was used to record events through electronic systems. Community Health Index (CHI) numbers were used to identify patients via electronic health records. Patient demographics and clinical characteristics such as age, comorbidities, Gleason staging, and readmission details accrued. Outcomes VTE within 90 days and development of a risk-stratified scoring system. All statistical analysis was performed using R-Statistical Software and the risk of VTE within 90 days of surgery was estimated via gradient-boosting decision trees (BRT) model. Results and limitations 1.1% (6/522) of patients developed deep vein thrombosis or pulmonary embolism within 3 months post-minimally invasive prostatectomy. Statistical analysis demonstrated a significant difference in the body mass index (p = 0.016), duration of hospital stay (p < 0.001), and number of readmissions (p = 0.036) between patients who developed VTE versus patients who did not develop VTE. BRT analysis found 8 variables that demonstrated relative importance in predicting VTE. The receiver operating curves (ROC) were constructed to assess the discrimination power of a new model. The model showed an AUC of 0.97 (95% confidence intervals [CI]: 0.945,0.999). For predicting VTE, a single-center study is a limitation.

Research paper thumbnail of Radiogenomics Reveals Correlation between Quantitative Texture Radiomic Features of Biparametric MRI and Hypoxia-Related Gene Expression in Men with Localised Prostate Cancer

Journal of Clinical Medicine

Objectives: To perform multiscale correlation analysis between quantitative texture feature pheno... more Objectives: To perform multiscale correlation analysis between quantitative texture feature phenotypes of pre-biopsy biparametric MRI (bpMRI) and targeted sequence-based RNA expression for hypoxia-related genes. Materials and Methods: Images from pre-biopsy 3T bpMRI scans in clinically localised PCa patients of various risk categories (n = 15) were used to extract textural features. The genomic landscape of hypoxia-related gene expression was obtained using post-radical prostatectomy tissue for targeted RNA expression profiling using the TempO-sequence method. The nonparametric Games Howell test was used to correlate the differential expression of the important hypoxia-related genes with 28 radiomic texture features. Then, cBioportal was accessed, and a gene-specific query was executed to extract the Oncoprint genomic output graph of the selected hypoxia-related genes from The Cancer Genome Atlas (TCGA). Based on each selected gene profile, correlation analysis using Pearson’s coeff...

Research paper thumbnail of Quantitative ultrasound shear wave elastography (USWE)-measured tissue stiffness correlates with PIRADS scoring of MRI and Gleason score on whole-mount histopathology of prostate cancer: implications for ultrasound image-guided targeting approach

Insights into Imaging, 2021

Objective To correlate quantitative tissue stiffness measurements obtained by transrectal ultraso... more Objective To correlate quantitative tissue stiffness measurements obtained by transrectal ultrasound shear wave elastography (USWE) with PI-RADS scoring of multiparametric magnetic imaging resonance (mpMRI) using Gleason scores of radical prostatectomy as a reference standard. Patients and methods 196 men with localised prostate cancer were prospectively recruited into the study and had quantitative prostate tissue stiffness measurements in kilopascals (kPa) using transrectal USWE prior to radical prostatectomy. PI-RADS scores of mpMRI were also obtained in all the men. Imaging and histopathology of radical prostatectomy specimen were oriented to each other using patient specific customised 3D moulds to guide histopathology grossing of radical prostatectomy specimens. All included patients had confirmed PCa on TRUS-guided biopsies, had both USWE and mpMRI imaging data, and underwent radical prostatectomy. Chi-square test with 95% confidence interval was used to assess the difference...

Research paper thumbnail of Diagnostic accuracy of image-guided biopsies in small (<4 cm) renal masses with implications for active surveillance: a systematic review of the evidence

The British journal of radiology, 2018

To determine the safety and diagnostic accuracy of renal tumour biopsies in a defined population ... more To determine the safety and diagnostic accuracy of renal tumour biopsies in a defined population of small renal masses (SRMs) only <4 cm using 3 × 2 table, intention to diagnose approach. 3 × 2 table approach examines indeterminate results as a separate category rather than pushing these through traditional 2 × 2 table (four-cell matrix) approach. A highly sensitive search was performed in the Cochrane Library, Database of Abstracts of Reviews of Effects; MEDLINE and MEDLINE in Process, EMBASE and conference proceedings (1966-2016) for the acquisition of data on the diagnostic accuracy and complications of RTB in patients with SRM <4 cm. Methodological quality and risk of bias was assessed using QUADAS-2. Test characteristics were calculated using conventional 2 × 2 contingency table analysis excluding non-diagnostic biopsies, and an intention-to-diagnose approach with a 3 × 2 table for pooled estimates of the sensitivity and specificity. A total of 20 studies were included wi...

Research paper thumbnail of A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers

European Journal of Oncology Nursing, 2018

A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention fo... more A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. 2018 PATERSON, C., PRIMEAU, C. and NABI, G. 2018. A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. European journal of oncology nursing [online], 37, pages 65-73.

Research paper thumbnail of Periprostatic Fat Adipokines Expression Correlated with Prostate Cancer Aggressiveness in Men Undergoing Radical Prostatectomy for Clinically Localised Disease

BJU international, Jan 3, 2018

To investigate relationship between periprostatic adipose tissue (PPAT) adipokines expression and... more To investigate relationship between periprostatic adipose tissue (PPAT) adipokines expression and PCa aggressiveness using both pathological features of radical prostatectomy (RP) and multiparametric MRI parameters. Sixty-nine men were recruited to assess immunohistochemical expression of TNFα- and VEGF of periprostatic fat of radical prostate specimens. Percent immunopositivity was quantified on scanned slides using Aperio Positive Pixel Count algorithm for PPAT TNFα, VEGF and androgen receptors. Periprostatic fat volume (PFV) was segmented on contiguous T -weighted axial MRI slices from the level of the prostate base to apex. PFV was normalised to prostate volume (PV) to account for variations in PV (NPFV=PFV/PV). MRI quantitative values (K , K and ADC) were measured from PCa primary lesion using OleaSphere software. Patients were stratified into three groups according to RP GS: ≤6, 7(3+4) and 7(4+3) or more. The mean rank of VEGF and TNFα were significantly different between the ...

Research paper thumbnail of Change in Nephrometry Scoring in Small Renal Masses (<4 cm) on Active Surveillance: Preliminary Observations From Tayside Active Surveillance Cohort (TASC) Study

Academic radiology, Jan 6, 2018

Prediction of growth, in particular knowing the possibility of aggressive cancer in small renal m... more Prediction of growth, in particular knowing the possibility of aggressive cancer in small renal masses on active surveillance, remains poorly understood. The study was designed to determine whether serial nephrometry score measurements could predict possibility of aggressive malignancy (grade of cancer) in patients with small renal masses opting for active surveillance initially. One hundred sixteen patients between January 2000 and December 2016 undergoing partial nephrectomy were recruited. Out of these, 97 were analyzed using different nephrometry scoring systems. Measurement of nephrometry scores (Radius of tumors, Exo/Endophytic; Nearness of tumors to the collecting system or sinus; Anterior/posterior; Location in relation to polar lines, Preoperative Aspects and Dimensions Used for Anatomical, Centrality Index) was performed by two researchers. Among the patients opting for partial nephrectomy, 40 were on active surveillance for at least 12 months (mean 32; 12-60 months) befor...

Research paper thumbnail of Microscale characterization of prostate biopsies tissues using optical coherence elastography and second harmonic generation imaging

Laboratory investigation; a journal of technical methods and pathology, Jan 18, 2017

Photonics, especially optical coherence elastography (OCE) and second harmonic generation (SHG) i... more Photonics, especially optical coherence elastography (OCE) and second harmonic generation (SHG) imaging are novel high-resolution imaging modalities for characterization of biological tissues. Following our preliminary experience, we hypothesized that OCE and SHG imaging would delineate the microstructure of prostate tissue and aid in distinguishing cancer from the normal benign prostatic tissue. Furthermore, these approaches may assist in characterization of the grade of cancer, as well. In this study, we confirmed a high diagnostic accuracy of OCE and SHG imaging in the detection and characterization of prostate cancer for a large set of biopsy tissues obtained from men suspected to have prostate cancer using transrectal ultrasound (TRUS). The two techniques and methods described here are complementary, one depicts the stiffness of tissues and the other illustrates the orientation of collagen structure around the cancerous lesions. The results showed that stiffness of cancer tissu...

Research paper thumbnail of Tumour suppressor gene (CDKNA2) status on chromosome 9p in resected renal tissue improves prognosis of localised kidney cancer

Oncotarget, Jan 22, 2016

Genetic alterations on chromosome 9p, including inactivation of the tumour suppressor gene, CDKN2... more Genetic alterations on chromosome 9p, including inactivation of the tumour suppressor gene, CDKN2A, result in cellular proliferation and growth of tumours. Our aim was to use microsatellite analysis and fluorescence in situ hybridization (FISH) to characterise the architecture of this region. Seventy-five out of 77 clear cell renal cell cancers (tumour/normal pairs) were interpretable for LOH analysis on chromosome 9p (two tumours were excluded, as all five primers were uninformative). Twenty out of 75 (26.6%) tumours showed LOH in at least one of the five primers employed. Most allelic deletions were detected, telomeric to the CDKN2A region at D9S916, with 11 out of 52 informative tumours (21%) displaying LOH. The LOH in the coding region of CDKN2A, at D9S974 and D9S942, was associated with a higher pT-stage (p = 0.004) and metastasis (p = 0.006, both markers). The rate of chromosome 9p deletion in ccRCC was 44% (35/80 cases) according to FISH. Somatic copy number loss of chromosom...

Research paper thumbnail of Microsatellite alteration and immunohistochemical expression profile of chromosome 9p21 in patients with sporadic renal cell carcinoma following surgical resection

BMC cancer, Jul 27, 2016

Long-term prognostic significance of loss of heterozygosity on chromosome 9p21 for localized rena... more Long-term prognostic significance of loss of heterozygosity on chromosome 9p21 for localized renal cell carcinoma following surgery remains unreported. The study assessed the frequency of deletions of different loci of chromosome 9p along with immunohistochemical profile of proteins in surgically resected renal cancer tissue and correlated this with long-term outcomes. DNA was extracted from renal tumours and corresponding normal kidney tissues in prospectively collected samples of 108 patients who underwent surgical resection for clinically localized disease between January 2001 and December 2005, providing a minimum of 9 years follow-up for each participant. After checking quality of DNA, amplified by PCR, loss of heterozygosity (LOH) on chromosome 9p was assessed using 6 microsatellite markers in 77 clear cell carcinoma. Only 5 of the markers showed LOH (D9S1814, D9S916, D9S974, D9S942, and D9S171). Protein expression of p15(INK4b), p16(INK4a), p14(ARF), CAIX, and adipose related...

Research paper thumbnail of Significance of chromosome 9p status in renal cell carcinoma: a systematic review and quality of the reported studies

BioMed research international, 2014

Defining the prognosis of renal cell carcinoma (RCC) using genetic tests is an evolving area. The... more Defining the prognosis of renal cell carcinoma (RCC) using genetic tests is an evolving area. The prognostic significance of 9p status in RCC, although described in the literature, remains underutilised in clinical practice. The study explored the causes of this translational gap. A systematic review on the significance of 9p status in RCC was performed to assess its clinical applicability and impact on clinical decision-making. Medline, Embase, and other electronic searches were made for studies reporting on 9p status in RCC. We collected data on: genetic techniques, pathological parameters, clinical outcomes, and completeness of follow-up assessment. Eleven studies reporting on 1,431 patients using different genetic techniques were included. The most commonly used genetic technique for the assessment of 9p status in RCC was fluorescence in situ hybridization. Combined genomic hybridisation (CGH), microsatellite analysis, karyotyping, and sequencing were other reported techniques. ...

Research paper thumbnail of Carcinoma In Situ Is Significantly Underdetected by Prenephroureterectomy Ureteroscopy in the Management of Upper Tract Urothelial Cancers

BioMed Research International, 2015

Objective. Diagnostic reliability of prenephroureterectomy ureteroscopy (PNU) for the detection o... more Objective. Diagnostic reliability of prenephroureterectomy ureteroscopy (PNU) for the detection of upper tract carcinoma in situ (CIS) remains unproven in particular and underreported in general.Methods. Patients who underwent radical nephroureterectomy (RNU) in a large multicentre retrospective study for upper tract transitional cell carcinoma (UT-TCC) between January 2002 and December 2013 were identified from our hospitals databases. PNU appearances, stage, and grade of ureteroscopic biopsy were compared with final histology results of RNU to assess the diagnostic reliability of PNU for carcinoma in situ (CIS).Results. Three hundred patients underwent RNU for UT-TCC. 106 (106/300; 35.3%) of the cohort had PNU using white light with biopsies taken in most (92/106; 86.7%). Postnephroureterectomy histology of the cohort showed CIS in 65 (65/300; 21.6%) patients. Thirty nine of patients with CIS (39/65; 60%) had prenephroureterectomy ureteroscopy biopsies. Out of ten patients with CI...

Research paper thumbnail of Comparative Assessment of Laparoscopic Single-Site Surgery Instruments to Conventional Laparoscopic in Laboratory Setting

Journal of Endourology, 2010

Introduction: Laparoendoscopic single-site surgery (LESS) represents the latest innovation in lap... more Introduction: Laparoendoscopic single-site surgery (LESS) represents the latest innovation in laparoscopic surgery. We compare in dry and animal laboratory the efficacy of recently introduced pre-bent instruments with conventional laparoscopic and flexible instruments in terms of time requirement, maneuvrability, and ease of handling. Materials and Methods: Participants of varying laparoscopic experience were included in the study and divided in groups according to their experience. The participants performed predetermined tasks in dry laboratory using all sets of instruments. An experienced laparoscopic surgeon performed 24 nephrectomies in 12 pigs using all sets of instruments. Single port was used for all instrument sets except for the conventional instruments, which were inserted through three ports. The time required for the performance of dry laboratory tasks and the porcine nephrectomies was recorded. Errors in the performance of dry laboratory tasks of each instrument type were also recorded. Results: Pre-bent instruments had a significant advantage over flexible instruments in terms of time requirement to accomplish tasks and procedures as well as maneuvrability. Flexible instruments were more time consuming in comparison to the conventional laparoscopic instruments during the performance of the tasks. There were no significant differences in the time required for the accomplishment of dry laboratory tasks or steps of nephrectomy using conventional instruments through appropriate number of ports in comparison to pre-bent instruments through single port. Discussion: Pre-bent instruments were less time consuming and with better maneuvrability in comparison to flexible instruments in experimental single-port access surgery. Further clinical investigations would elucidate the efficacy of pre-bent instruments.

Research paper thumbnail of Selective sampling using confocal Raman spectroscopy provides enhanced specificity for urinary bladder cancer diagnosis

Analytical and Bioanalytical Chemistry, 2012

Research paper thumbnail of Optical redox ratio and endogenous porphyrins in the detection of urinary bladder cancer: A patient biopsy analysis

Journal of biophotonics, Jan 7, 2016

Bladder cancer is among the most common cancers in the UK and conventional detection techniques s... more Bladder cancer is among the most common cancers in the UK and conventional detection techniques suffer from low sensitivity, low specificity, or both. Recent attempts to address the disparity have led to progress in the field of autofluorescence as a means to diagnose the disease with high efficiency, however there is still a lot not known about autofluorescence profiles in the disease. The multi-functional diagnostic system "LAKK-M" was used to assess autofluorescence profiles of healthy and cancerous bladder tissue to identify novel biomarkers of the disease. Statistically significant differences were observed in the optical redox ratio (a measure of tissue metabolic activity), the amplitude of endogenous porphyrins and the NADH/porphyrin ratio between tissue types. These findings could advance understanding of bladder cancer and aid in the development of new techniques for detection and surveillance.

Research paper thumbnail of Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease

Insights into Imaging

Objectives To compare the accuracy of pre-surgical prostate size measurements using mpMRI and USW... more Objectives To compare the accuracy of pre-surgical prostate size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology, and to assess whether size assessment varies between clinically significant and non-significant cancerous lesions including their locations in different zones of the prostate. Methods The study population included 202 men with clinically localised prostate cancer opting for radical surgery derived from two prospective studies. Protocol-based imaging data was used for measurement of size of prostate cancer in clinically localised disease using MRI (N = 106; USWE (N = 96). Forty-eight men overlapped between two studies and formed the validation cohort. The primary outcome of this study was to assess the accuracy of pre-surgical prostate cancerous size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology as a reference stan...

Research paper thumbnail of Pelvic Lipomatosis Presenting as Uraemic Encephalopathy

International Journal of Clinical Practice

Pelvic lipomatosis is a benign disorder of unknown aetiology, characterised by deposition of matu... more Pelvic lipomatosis is a benign disorder of unknown aetiology, characterised by deposition of mature fat in the pelvis. It has a variable natural history, manifesting either with symptoms attributable to the lower urinary tract or varying degrees of renal failure. Owing to the mild, non-specific initial symptoms and slow progression, presentation is delayed and patients are often lost to follow-up, only to present with advanced renal failure later on. We report a case of a young patient with pelvic lipomatosis who, after an initial diagnosis, was lost to follow-up for several years and then presented with uraemic encephalopathy. The case highlights the importance of regular follow-up and an early intervention before irreversible changes occur.

Research paper thumbnail of Evaluation of Lemon Varieties on Australian Bigarade Rootstock

An experiment “Evaluation of lemon varieties on Australian Bigarade rootstock in the climatic con... more An experiment “Evaluation of lemon varieties on Australian Bigarade rootstock in the climatic conditions of Malakand” was conducted at Subtropical Germplasm Unit Sherkhana Malakand during 2014. Four lemon varieties i.e., Mesero, Lisbon, Eureka and Foothill eureka were budded on Australian Bigarade (Citrus auriantium) rootstock in 2006. Experiment was laid out as single factor Randomized Complete Block Design. There were four replications per treatment (variety), each tree was considered as one replicate. The results revealed that Corona foothill Eureka gained significant vigorous tree growth 4.02 m taller and 4.38 m expanded canopy spread, while trunk circumference/girth was more in Lisbon (75.33 cm), followed by Corona Foothill Eureka (71.67 cm). Statistically, there were no differences in bloom time and the fruit set per twig. However, numbers of flowers per twig were significantly more in Lisbon (35.33) followed by Mesero (27). The highest fruits were set by Corona foothill Eurek...

Research paper thumbnail of Complex Renal Cysts (Bosniak ≥ IIF): Outcomes in a Population-Based Cohort Study

Cancers, 2020

There is emerging evidence to suggest that con-current medical conditions influence the outcome o... more There is emerging evidence to suggest that con-current medical conditions influence the outcome of cancers, irrespective of therapy offered. The prevalence and impact of co-morbidities on the survival outcome of complex renal cystic masses in not known. The objective was to study complex renal cysts (Bosniak ≥IIF ) and assess the overall and renal cancer-specific survival in a population-based database including impact of con-current morbidities. The Tayside Urological Cancer Network (TUCAN) database covering a stable population of more than 416,090 inhabitants in a defined geographical area identified 452 complex renal cysts in 415 patients between 2009 and 2019. Each patient was tracked and followed up using a unique identifier and deterministic linkage methodology. The last date of follow-up including cause of death was determined. Co-morbidities were recorded from primary care referrals. Renal cancer-specific mortality was 1.7% at a median follow-up of 76.0 months; however, over...