Comparison of Prostate Biopsy with or without Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Detection: An Observational Cohort Study

We hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and 2) this would inform recommendations regarding systematic transrectal prostate biopsy in the setting of negative prebiopsy multiparametric m...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:The Journal of urology Ročník 201; číslo 3; s. 510
Hlavní autoři: Bryant, Richard J, Hobbs, Catherine P, Eyre, Katie S, Davies, Lucy C, Sullivan, Mark E, Shields, William, Sooriakumaran, Prasanna, Verrill, Clare L, Gleeson, Fergus V, MacPherson, Ruth E, Hamdy, Freddie C, Brewster, Simon F
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.03.2019
Témata:
ISSN:1527-3792, 1527-3792
On-line přístup:Zjistit podrobnosti o přístupu
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Abstract We hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and 2) this would inform recommendations regarding systematic transrectal prostate biopsy in the setting of negative prebiopsy multiparametric magnetic resonance imaging. A total of 997 biopsy naïve patients underwent transrectal prostate biopsy alone to June 2016 (cohort 1) and thereafter 792 underwent transrectal prostate biopsy following prebiopsy multiparametric magnetic resonance imaging (cohort 2). Patients with lesions on prebiopsy multiparametric magnetic resonance imaging underwent cognitive targeted plus systematic transrectal prostate biopsy. Patients without lesions underwent systematic transrectal prostate biopsy. Cohort 2 comprised younger men (age 68 vs 69 years, p = 0.01) with lower prostate specific antigen (7.6 vs 7.9 ng/ml, p = 0.024) and smaller prostate volume (56.1 vs 62 cc, p = 0.006). In cohort 2 vs cohort 1 there was no increase in overall prostate cancer detection (57.6% vs 56.7%, p = 0.701), the Gleason Grade Group or the number of positive cores (each p >0.05). Increased multifocal prostatic intraepithelial neoplasia, maximum prostate cancer core length (5 mm or greater vs less than 5 mm) and radical surgery/high intensity focused ultrasound (each p <0.05) were observed in cohort 2. For Gleason Grade Group 2-5 prostate cancer negative prebiopsy multiparametric magnetic resonance imaging had 88.1% sensitivity, 59.8% specificity, 67.8% positive predictive value and 84% negative predictive value. For negative prebiopsy multiparametric magnetic resonance images a prostate specific antigen density cutoff of 0.15 ng/ml or greater increased clinically significant prostate cancer detection only if the latter was defined as Gleason Grade Group 3-5 disease and/or tumor length 6 mm or greater. Introducing prebiopsy multiparametric magnetic resonance imaging in our clinical setting increased the diagnostic yield of prostate cancer per biopsy core. Not performing a systematic transrectal prostate biopsy when prebiopsy multiparametric magnetic resonance imaging was negative would have led to under detection of 15.1% of Gleason Grade Group 2 or greater prostate cancer cases (approximately 1 in 6).
AbstractList We hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and 2) this would inform recommendations regarding systematic transrectal prostate biopsy in the setting of negative prebiopsy multiparametric magnetic resonance imaging. A total of 997 biopsy naïve patients underwent transrectal prostate biopsy alone to June 2016 (cohort 1) and thereafter 792 underwent transrectal prostate biopsy following prebiopsy multiparametric magnetic resonance imaging (cohort 2). Patients with lesions on prebiopsy multiparametric magnetic resonance imaging underwent cognitive targeted plus systematic transrectal prostate biopsy. Patients without lesions underwent systematic transrectal prostate biopsy. Cohort 2 comprised younger men (age 68 vs 69 years, p = 0.01) with lower prostate specific antigen (7.6 vs 7.9 ng/ml, p = 0.024) and smaller prostate volume (56.1 vs 62 cc, p = 0.006). In cohort 2 vs cohort 1 there was no increase in overall prostate cancer detection (57.6% vs 56.7%, p = 0.701), the Gleason Grade Group or the number of positive cores (each p >0.05). Increased multifocal prostatic intraepithelial neoplasia, maximum prostate cancer core length (5 mm or greater vs less than 5 mm) and radical surgery/high intensity focused ultrasound (each p <0.05) were observed in cohort 2. For Gleason Grade Group 2-5 prostate cancer negative prebiopsy multiparametric magnetic resonance imaging had 88.1% sensitivity, 59.8% specificity, 67.8% positive predictive value and 84% negative predictive value. For negative prebiopsy multiparametric magnetic resonance images a prostate specific antigen density cutoff of 0.15 ng/ml or greater increased clinically significant prostate cancer detection only if the latter was defined as Gleason Grade Group 3-5 disease and/or tumor length 6 mm or greater. Introducing prebiopsy multiparametric magnetic resonance imaging in our clinical setting increased the diagnostic yield of prostate cancer per biopsy core. Not performing a systematic transrectal prostate biopsy when prebiopsy multiparametric magnetic resonance imaging was negative would have led to under detection of 15.1% of Gleason Grade Group 2 or greater prostate cancer cases (approximately 1 in 6).
We hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and 2) this would inform recommendations regarding systematic transrectal prostate biopsy in the setting of negative prebiopsy multiparametric magnetic resonance imaging.PURPOSEWe hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and 2) this would inform recommendations regarding systematic transrectal prostate biopsy in the setting of negative prebiopsy multiparametric magnetic resonance imaging.A total of 997 biopsy naïve patients underwent transrectal prostate biopsy alone to June 2016 (cohort 1) and thereafter 792 underwent transrectal prostate biopsy following prebiopsy multiparametric magnetic resonance imaging (cohort 2). Patients with lesions on prebiopsy multiparametric magnetic resonance imaging underwent cognitive targeted plus systematic transrectal prostate biopsy. Patients without lesions underwent systematic transrectal prostate biopsy.MATERIALS AND METHODSA total of 997 biopsy naïve patients underwent transrectal prostate biopsy alone to June 2016 (cohort 1) and thereafter 792 underwent transrectal prostate biopsy following prebiopsy multiparametric magnetic resonance imaging (cohort 2). Patients with lesions on prebiopsy multiparametric magnetic resonance imaging underwent cognitive targeted plus systematic transrectal prostate biopsy. Patients without lesions underwent systematic transrectal prostate biopsy.Cohort 2 comprised younger men (age 68 vs 69 years, p = 0.01) with lower prostate specific antigen (7.6 vs 7.9 ng/ml, p = 0.024) and smaller prostate volume (56.1 vs 62 cc, p = 0.006). In cohort 2 vs cohort 1 there was no increase in overall prostate cancer detection (57.6% vs 56.7%, p = 0.701), the Gleason Grade Group or the number of positive cores (each p >0.05). Increased multifocal prostatic intraepithelial neoplasia, maximum prostate cancer core length (5 mm or greater vs less than 5 mm) and radical surgery/high intensity focused ultrasound (each p <0.05) were observed in cohort 2. For Gleason Grade Group 2-5 prostate cancer negative prebiopsy multiparametric magnetic resonance imaging had 88.1% sensitivity, 59.8% specificity, 67.8% positive predictive value and 84% negative predictive value. For negative prebiopsy multiparametric magnetic resonance images a prostate specific antigen density cutoff of 0.15 ng/ml2 or greater increased clinically significant prostate cancer detection only if the latter was defined as Gleason Grade Group 3-5 disease and/or tumor length 6 mm or greater.RESULTSCohort 2 comprised younger men (age 68 vs 69 years, p = 0.01) with lower prostate specific antigen (7.6 vs 7.9 ng/ml, p = 0.024) and smaller prostate volume (56.1 vs 62 cc, p = 0.006). In cohort 2 vs cohort 1 there was no increase in overall prostate cancer detection (57.6% vs 56.7%, p = 0.701), the Gleason Grade Group or the number of positive cores (each p >0.05). Increased multifocal prostatic intraepithelial neoplasia, maximum prostate cancer core length (5 mm or greater vs less than 5 mm) and radical surgery/high intensity focused ultrasound (each p <0.05) were observed in cohort 2. For Gleason Grade Group 2-5 prostate cancer negative prebiopsy multiparametric magnetic resonance imaging had 88.1% sensitivity, 59.8% specificity, 67.8% positive predictive value and 84% negative predictive value. For negative prebiopsy multiparametric magnetic resonance images a prostate specific antigen density cutoff of 0.15 ng/ml2 or greater increased clinically significant prostate cancer detection only if the latter was defined as Gleason Grade Group 3-5 disease and/or tumor length 6 mm or greater.Introducing prebiopsy multiparametric magnetic resonance imaging in our clinical setting increased the diagnostic yield of prostate cancer per biopsy core. Not performing a systematic transrectal prostate biopsy when prebiopsy multiparametric magnetic resonance imaging was negative would have led to under detection of 15.1% of Gleason Grade Group 2 or greater prostate cancer cases (approximately 1 in 6).CONCLUSIONSIntroducing prebiopsy multiparametric magnetic resonance imaging in our clinical setting increased the diagnostic yield of prostate cancer per biopsy core. Not performing a systematic transrectal prostate biopsy when prebiopsy multiparametric magnetic resonance imaging was negative would have led to under detection of 15.1% of Gleason Grade Group 2 or greater prostate cancer cases (approximately 1 in 6).
Author Shields, William
Hobbs, Catherine P
Bryant, Richard J
MacPherson, Ruth E
Davies, Lucy C
Sooriakumaran, Prasanna
Gleeson, Fergus V
Hamdy, Freddie C
Verrill, Clare L
Brewster, Simon F
Sullivan, Mark E
Eyre, Katie S
Author_xml – sequence: 1
  givenname: Richard J
  surname: Bryant
  fullname: Bryant, Richard J
  organization: Nuffield Departments of Surgical Sciences, University of Oxford , Oxford , United Kingdom
– sequence: 2
  givenname: Catherine P
  surname: Hobbs
  fullname: Hobbs, Catherine P
  organization: Department of Urology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
– sequence: 3
  givenname: Katie S
  surname: Eyre
  fullname: Eyre, Katie S
  organization: Department of Urology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
– sequence: 4
  givenname: Lucy C
  surname: Davies
  fullname: Davies, Lucy C
  organization: Nuffield Departments of Population Health, University of Oxford , Oxford , United Kingdom
– sequence: 5
  givenname: Mark E
  surname: Sullivan
  fullname: Sullivan, Mark E
  organization: Department of Urology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
– sequence: 6
  givenname: William
  surname: Shields
  fullname: Shields, William
  organization: Department of Urology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
– sequence: 7
  givenname: Prasanna
  surname: Sooriakumaran
  fullname: Sooriakumaran, Prasanna
  organization: Department of Uro-Oncology, University College London Hospital National Health Service Foundation Trust , London , United Kingdom
– sequence: 8
  givenname: Clare L
  surname: Verrill
  fullname: Verrill, Clare L
  organization: Nuffield Departments of Surgical Sciences, University of Oxford , Oxford , United Kingdom
– sequence: 9
  givenname: Fergus V
  surname: Gleeson
  fullname: Gleeson, Fergus V
  organization: Department of Radiology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
– sequence: 10
  givenname: Ruth E
  surname: MacPherson
  fullname: MacPherson, Ruth E
  organization: Department of Radiology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
– sequence: 11
  givenname: Freddie C
  surname: Hamdy
  fullname: Hamdy, Freddie C
  organization: Nuffield Departments of Surgical Sciences, University of Oxford , Oxford , United Kingdom
– sequence: 12
  givenname: Simon F
  surname: Brewster
  fullname: Brewster, Simon F
  organization: Department of Urology, Oxford University Hospitals National Health Service Foundation Trust, University of Oxford , Oxford , United Kingdom
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30266332$$D View this record in MEDLINE/PubMed
BookMark eNpNkEtPGzEUha0KVAjlD3RRedlNpn7Mszs6lIdEFERhHd2xr4OjGTu1PVT5NfzVToCirs65Oud-izMjB847JOQzZxlnvPy2yTZj8JlgvM5Yk7G8-UCOeSGquawacfCfPyKzGDeM8byoxEdyJJkoSynFMXlu_bCFYKN31Bt6G3xMkJD-sH4bd_SPTY_Uhxf1Y5py7F6TxdgnO33CgClYRRewdpgmc4cTC5xCej3A2ro1NRPgHdzuo0DPMaFK1rvv9MzRZRcxPMH-hp62_tGHRH-lUe8-kUMDfcTTNz0hDxc_79ur-c3y8ro9u5kryWSa50UNRhlVK4maY5cXvOqgNHkBoHRemrLoRGlAaq2xZo3WvDOylgXUWuWiEifk6yt3G_zvEWNaDTYq7Htw6Me4EpznZSM531e_vFXHbkC92gY7QNit_o0q_gIEt4ET
CitedBy_id crossref_primary_10_1111_bju_15978
crossref_primary_10_1007_s00261_021_03179_5
crossref_primary_10_1148_radiol_2019182946
crossref_primary_10_1002_pros_24669
crossref_primary_10_1007_s00092_019_2059_7
crossref_primary_10_1016_j_eururo_2018_12_031
crossref_primary_10_1016_S1470_2045_25_00100_7
crossref_primary_10_1111_bju_15355
crossref_primary_10_1016_j_urolonc_2021_12_016
crossref_primary_10_1097_CCO_0000000000000625
crossref_primary_10_1177_2051415820932773
crossref_primary_10_1016_j_eururo_2020_03_048
crossref_primary_10_1111_bju_15093
crossref_primary_10_1002_prca_202000025
crossref_primary_10_1002_cnr2_1668
crossref_primary_10_1177_20514158211059057
crossref_primary_10_1016_j_euros_2021_03_008
crossref_primary_10_1515_med_2024_1048
crossref_primary_10_1186_s13063_024_08224_4
crossref_primary_10_3389_fonc_2022_973285
crossref_primary_10_1038_s41391_021_00330_7
ContentType Journal Article
DBID CGR
CUY
CVF
ECM
EIF
NPM
7X8
DOI 10.1016/j.juro.2018.09.049
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
DatabaseTitleList MEDLINE
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: 7X8
  name: MEDLINE - Academic
  url: https://search.proquest.com/medline
  sourceTypes: Aggregation Database
DeliveryMethod no_fulltext_linktorsrc
Discipline Medicine
EISSN 1527-3792
ExternalDocumentID 30266332
Genre Journal Article
Comparative Study
Observational Study
GrantInformation_xml – fundername: Cancer Research UK
  grantid: 22748
GroupedDBID ---
--K
.55
.GJ
.XZ
08P
0R~
123
1B1
1CY
354
3O-
4.4
457
4G.
4Q1
4Q2
4Q3
53G
5RE
5VS
7-5
AAAAV
AAEDT
AAEDW
AAGIX
AAHPQ
AAIQE
AAJCS
AAKAS
AALRI
AAMOA
AAQFI
AAQKA
AAQQT
AAQXK
AASCR
AASXQ
AAXUO
ABASU
ABCQX
ABDIG
ABJNI
ABLJU
ABMAC
ABOCM
ABPPZ
ABPXF
ABVCZ
ABWVN
ABXYN
ABZZY
ACGFS
ACILI
ACLDA
ACOAL
ACRPL
ACVFH
ACXJB
ACZKN
ADCNI
ADGGA
ADGHP
ADHPY
ADMUD
ADNKB
ADNMO
ADZCM
AEBDS
AEETU
AENEX
AFBFQ
AFDTB
AFEXH
AFFNX
AFNMH
AFTRI
AFUWQ
AGHFR
AGQPQ
AHOMT
AHQNM
AHQVU
AHRYX
AHVBC
AI.
AIGII
AINUH
AITUG
AIZYK
AJCLO
AJIOK
AJNWD
AJZMW
AKCTQ
AKULP
ALKUP
ALMA_UNASSIGNED_HOLDINGS
ALMTX
AMJPA
AMKUR
AMNEI
AMRAJ
AOQMC
ASGHL
ASPBG
AVWKF
AZFZN
BCGUY
BELOY
BYPQX
C45
C5W
CGR
CS3
CUY
CVF
DIWNM
DU5
EBS
ECM
EEVPB
EIF
EJD
ERAAH
EX3
F5P
FCALG
FDB
FEDTE
FGOYB
GBLVA
GNXGY
GQDEL
HLJTE
HVGLF
HZ~
H~9
IH2
IHE
IKREB
IKYAY
IPNFZ
J5H
KMI
L7B
M41
MJL
MO0
N4W
NPM
NQ-
NTWIH
O9-
OAG
OAH
OB3
OBH
ODMTH
OGROG
OHH
OL1
OVD
OWU
OWV
OWW
OWY
OWZ
P2P
QTD
R2-
RIG
RLZ
ROL
RPZ
SEL
SES
SJN
SSZ
TEORI
TSPGW
UDS
UNMZH
UV1
VH1
VVN
WOW
X7M
XH2
XYM
YFH
YOC
ZCG
ZFV
ZGI
ZXP
ZY1
ZZMQN
7X8
ACBKD
ADKSD
ADSXY
ID FETCH-LOGICAL-c303t-458afcfc8c3ed1eb4517ba6f45aacd46f65b26fa3ddde809dd1bf3835a8dc4272
IEDL.DBID 7X8
ISICitedReferencesCount 27
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000475762000036&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 1527-3792
IngestDate Sun Nov 09 10:52:40 EST 2025
Mon Jul 21 06:08:08 EDT 2025
IsPeerReviewed true
IsScholarly true
Issue 3
Keywords biopsy
diagnosis
prostate specific antigen
magnetic resonance imaging
prostatic neoplasms
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c303t-458afcfc8c3ed1eb4517ba6f45aacd46f65b26fa3ddde809dd1bf3835a8dc4272
Notes ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ObjectType-Undefined-3
PMID 30266332
PQID 2114693117
PQPubID 23479
ParticipantIDs proquest_miscellaneous_2114693117
pubmed_primary_30266332
PublicationCentury 2000
PublicationDate 2019-03-00
20190301
PublicationDateYYYYMMDD 2019-03-01
PublicationDate_xml – month: 03
  year: 2019
  text: 2019-03-00
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle The Journal of urology
PublicationTitleAlternate J Urol
PublicationYear 2019
References 30759693 - J Urol. 2019 Mar;201(3):518. doi: 10.1097/01.JU.0000553709.74021.24.
References_xml – reference: 30759693 - J Urol. 2019 Mar;201(3):518. doi: 10.1097/01.JU.0000553709.74021.24.
SSID ssj0014572
Score 2.4256916
Snippet We hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and...
SourceID proquest
pubmed
SourceType Aggregation Database
Index Database
StartPage 510
SubjectTerms Aged
Biopsy
Cohort Studies
Humans
Magnetic Resonance Imaging
Male
Preoperative Period
Prostate - diagnostic imaging
Prostate - pathology
Prostatic Neoplasms - diagnostic imaging
Prostatic Neoplasms - pathology
Title Comparison of Prostate Biopsy with or without Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Detection: An Observational Cohort Study
URI https://www.ncbi.nlm.nih.gov/pubmed/30266332
https://www.proquest.com/docview/2114693117
Volume 201
WOSCitedRecordID wos000475762000036&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3JTsMwELWAIsSFfV9kJK4ROHYWc0GlUMGhpQeQeqtsx2aRSEraIvE1_CozTkpvCIlLchglsuyZ8eyPkFPDMgfnrIM4FuCgSJA5zRQYcsIaF8VWpLwCm0i63bTfl7064DaqyyqnOtEr6qwwGCM_C7F9VnLGksvhe4CoUZhdrSE05kmDgymDXJ30Z1kEEXnwJkRuBUGSYd00U9V3vU5KbP5jqZ9zKn4xMf1V01797yLXyEptZNJmxRXrZM7mG2SpU6fRN8lX6wd9kBaO9rDzA2xOevVSDEefFGOztCj9u5iMgW51RfHtujgt_A2BuAztqKccuyApZgFwdIeld28e94iCMTz7cQtJJb22Y1_5lV_QZk7v9U9EGBbbKp7BE6BY1_i5RR7bNw-t26BGaggMXIHjQESpcsaZ1HCbMatFxBKtYicipUwmYhdHOoyd4hlo0_RcZhnTDnzjSKWZEWESbpOFvMjtLqFWCMWkdiaUWjhw79JQM1BDiZLgrHO7R06mWz8AScD0hsptMRkNZpu_R3aq8xsMq5EdAw6uZsx5uP-Hrw_IMrCFrArNDknDgR6wR2TRfIxfRuWxZzF4dnudbwwZ324
linkProvider ProQuest
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Comparison+of+Prostate+Biopsy+with+or+without+Prebiopsy+Multiparametric+Magnetic+Resonance+Imaging+for+Prostate+Cancer+Detection%3A+An+Observational+Cohort+Study&rft.jtitle=The+Journal+of+urology&rft.au=Bryant%2C+Richard+J&rft.au=Hobbs%2C+Catherine+P&rft.au=Eyre%2C+Katie+S&rft.au=Davies%2C+Lucy+C&rft.date=2019-03-01&rft.eissn=1527-3792&rft.volume=201&rft.issue=3&rft.spage=510&rft_id=info:doi/10.1016%2Fj.juro.2018.09.049&rft_id=info%3Apmid%2F30266332&rft_id=info%3Apmid%2F30266332&rft.externalDocID=30266332
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1527-3792&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1527-3792&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1527-3792&client=summon