			Home About us Contact

TRUS Findings (TRU + finding)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Predictors of prostate cancer on repeat transrectal ultrasound-guided systematic prostate biopsy

INTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2003
SOO-JEON PARK
AbstractBackground: We analyzed the outcome of repeated transrectal ultrasound (TRUS)-guided systematic prostate biopsy in Japanese men whose clinical findings were suspected of prostate cancer after previous negative biopsies. Methods: Between January 1993 and March 2002, 1045 patients underwent TRUS-guided prostate biopsy. Among them, 104 patients underwent repeat biopsy due to indications of persistent elevated serum prostate-specific antigen (PSA), abnormal digital rectal examination (DRE) or TRUS, increased PSA velocity, and/or previous suspicious biopsy findings. Several clinicopathological factors were evaluated for their ability to predict the detection of prostate cancer on repeat biopsy. Results: Prostate cancer was detected in 22 of 104 patients (21.2%) who underwent repeat biopsies. PSA concentration and PSA density at both the initial and repeat biopsies, and PSA velocity in men with positive repeat biopsy were significantly greater than those in men with negative repeat biopsy. The incidence of abnormal findings in DRE and TRUS at initial biopsy in men with positive repeat biopsy was also significantly higher than that in men with negative repeat biopsy. However, neither the presence of prostatic intraepithelial neoplasia nor number of biopsy cores at initial biopsy had a significant association with the results of the repeat biopsy. Furthermore, multivariate analysis revealed that PSA and PSA density at both the initial and repeat biopsies, PSA velocity, and DRE and TRUS findings at initial biopsy were independent predictors of malignant disease on repeat biopsy. Conclusion: Despite an initial negative biopsy, repeat TRUS-guided biopsy should be carried out to exclude prostate cancer in cases of suspicious clinical findings, such as elevated PSA or PSA-related parameters, or abnormal findings of DRE or TRUS. [source]

A rare case of granulomatous prostatitis caused by Mycobacterium tuberculosis

JOURNAL OF CLINICAL ULTRASOUND, Issue 1 2007
Sadýk Tamsel MD
Abstract We report a rare case of infective granulomatous prostatitis caused by Mycobacterium tuberculosis that may be mistaken for prostatic carcinoma, both on clinical examination and transrectal sonography (TRUS). A large hypoechoic mass was detected in the prostate of a 46-year-old man during TRUS and histopathologic examination after TRUS-guided biopsies reported the diagnosis of tuberculous prostatitis. We herein describe the clinical and TRUS findings of this case. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2006 [source]

Role of systematic ultrasound-guided staging biopsies in predicting extraprostatic extension and seminal vesicle invasion in men with prostate cancer

JOURNAL OF CLINICAL ULTRASOUND, Issue 3 2002
Koji Okihara MD
Abstract Purpose To assess the presence of extraprostatic extension and seminal vesicle invasion in men with prostate cancer, we performed systematic staging biopsies targeting neurovascular bundles, seminal vesicles, and other extraprostatic tissues before the men underwent radical prostatectomy. We retrospectively evaluated the clinical efficacy of these systematic staging biopsies compared with digital rectal examination (DRE) and transrectal sonography (TRUS). Methods Two hundred forty-four candidates for prostatectomy who had a diagnostic biopsy Gleason score of 8 or higher and/or indications of extraprostatic extension (eg, seminal vesicle invasion) by DRE or TRUS underwent staging biopsies using an 18-gauge Tru-Cut needle under real-time TRUS guidance between June 1997 and March 2000. We determined the number of staging biopsy cores to be taken based on the Gleason score of the diagnostic biopsy as well as abnormal DRE and/or TRUS findings. The chi-square test was used to evaluate the statistical significance of differences. Results There were no complications of staging biopsy. In 75 (31%) of the 244 patients, results of the staging biopsies were positive. The clinical stage was upgraded by staging biopsy in 18 (24%) of these 75 patients. After the staging biopsies, 90 patients underwent radical prostatectomy. Among these 90 patients, staging biopsy specimens were positive for cancer in 20 (47%) of the 43 patients who received neoadjuvant therapy and in 1 (2%) of the 47 patients who did not receive neoadjuvant therapy. There were no false-positive staging biopsies in either group. Among the 90 patients who underwent radical prostatectomy, the false-negative rate for the prediction of organ-confined disease was 43% (30/69) for staging biopsies compared with 29% (10/34) for TRUS. The diagnostic accuracy of staging biopsies (67%; 60/90) was higher than that of DRE (52%; 47/90; p < 0.05) but lower than that of TRUS (79%; 71/90; p = 0.066). Conclusions Staging biopsies can reliably sample extraprostatic tissue, including the seminal vesicles and neurovascular bundles. Positive staging biopsy results can aid in the selection of treatment options and in the prediction of outcome for individual patients by providing definitive histologic confirmation of locally advanced disease. Conventional predictive variables for staging can be applied when the results of staging biopsies are negative. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:123,131, 2002; DOI 10.1002/jcu.10052 [source]

The adjunctive use of power Doppler imaging in the preoperative assessment of prostate cancer

BJU INTERNATIONAL, Issue 9 2010
Michael L. Eisenberg
Study Type , Diagnostic (exploratory cohort) Level of Evidence 2b OBJECTIVE To determine if the adjunctive use of power Doppler imaging (PDI) could provide prognostic utility in the treatment of prostate cancer, as an accurate prediction of the clinical behaviour of prostate cancer is important to determine appropriate treatment. PATIENTS AND METHODS Most centres rely on a digital rectal examination or transrectal ultrasonography (TRUS) to assess the clinical stage of patients. In 2002, we began using a standardized form to evaluate TRUS findings and PDI findings. We compared preoperative clinical findings with those from pathological analysis of 620 radical prostatectomy specimens from 2002 to 2007. RESULTS The mean (sd) patient age was 58 (6.6) years with a mean prostate-specific antigen (PSA) level of 7.0 (4.5) ng/mL. Of the 620 specimens 157 (25.3%) had evidence of extracapsular extension on pathological evaluation; 443 (71.5%) men had a hypervascular lesion seen on TRUS, while 177 (28.5%) patients had none. There was no difference in preoperative PSA level, grade or stage of tumour. Furthermore, rates of biochemical recurrence or secondary treatment did not differ based on PDI findings. As a tool to help locate prostate tumours, PDI improved the specificity of TRUS but did not improve the overall accuracy or sensitivity. CONCLUSION PDI provides little prognostic utility to assess risk in prostate cancer. However, PDI might improve the specificity of TRUS in identifying prostate tumours and could have a role in image guidance for focal therapy of prostate cancer. [source]