Параректальная fusion-биопсия предстательной железы под контролем компьютерной томографии

Background. Prostate cancer (PCa) is one of the most common malignancies. The gold standard of PCa diagnostics is morphological examination of prostate tissues obtained using 10-12-core biopsy. However, the number of false-negative results and detected clinically insignificant forms of cancer remain high. Magnetic resonance imaging (MRI) is the most sensitive and specific method of radiation diagnosis of PCa. The use of MRI data for prostate biopsy (fusion-biopsy) increases the accuracy of this procedure.Objective: to increase the accuracy of PCa diagnostics using targeted pararectal prostate biopsy guided by computed tomography (CT)/MRI.Materials and methods. A total of 95 patients underwent CT/MRI-guided targeted pararectal biopsy between March 2015 and March 2020. The mean level of prostate specific antigen (PSA) was 13.7 ± 12.6 ng/mL. All men were found to have 1 to 3 lesions with a PI-RADS score between 3 and 5.Patients were divided into 4 groups: 1st group (n = 33) included patients in whom transrectal access was impossible; 2nd group (n = 22) included patients with suspected local recurrence of PCa after brachytherapy; 3rd group (n = 28) included patients with a negative result of primary biopsy, but with growing PSA level; 4th group (n = 12) included patients who preferred targeted biopsy. We performed targeted biopsy of each suspicious lesion according to MRIscans. Then we performed ‘blind’ systematic 10-14-core biopsy, where we did not take into account the location of suspicious foci and they could be, therefore, accidentally used for sample collection for the second time.Results. Histological examination revealed PCa in 71 out of 95 patients (74.7 %): in 27 out of 33 in 1st group (81.8 %), in 19 out of 22 in 2nd group (86.4 %), in 17 out of 28 in 3rd group (60.7 %), and in 8 out of 12 in 4th group (66.7 %). In 21 patients (29.6 %), PCa was diagnosed only in samples obtained using targeted biopsy; in 9 patients (12.7 %), PCa was diagnosed only in samples after systematic biopsy; in 41 patients (57.7 % PCa was detected by both targeted and systematic biopsy. Clinically significant cancer (Gleason score ≥7) was diagnosed in 84.5 % of cases after targeted biopsy and in 70.4 % of cases after systemic biopsy.Conclusion. CT/MRI-guided prostate fusion biopsy increases the accuracy of PCa diagnostics by additional detection of clinically significant tumors, including those in patients in whom the rectal access is impossible.Введение. Рак предстательной железы (РПЖ) — одно из самых распространенных онкологических заболеваний. «Золотой стандарт» диагностики — морфологическое исследование тканей предстательной железы, полученных при 10—12-точечной биопсии. Однако число ложноотрицательных результатов и обнаружение клинически незначимых форм рака остаются высокими. Магнитно-резонансная томография (МРТ) — самый чувствительный и специфичный метод лучевой диагностики РПЖ. Использование данных МРТ при выполнении биопсии предстательной железы (fusion-биопсия) повышает точность этой процедуры.Цель исследования — повысить эффективность диагностики РПЖ путем применения методики прицельной параректальной биопсии предстательной железы с использованием совмещенных изображений компьютерной томографии и МРТ.Материалы и методы. С февраля 2015 г. по март 2020 г. прицельная параректальная биопсия с использованием совмещенных изображений компьютерной томографии и МРТ была выполнена 95 пациентам. Средний уровень простатического специфического антигена составил 13,7 ± 12,6 нг/мл. У всех мужчин в структуре предстательной железы было выявлено от 1 до 3 очагов, оцененных по системе PI-RADS от 3 до 5 баллов.Пациенты были распределены на 4 группы: 1-я (n = 33) — пациенты с отсутствием возможности трансректального доступа; 2-я (п = 22) — пациенты с подозрением на локальный рецидив РПЖ после брахитерапии; 3-я (п = 28) — пациенты с отрицательным результатом первичной биопсии, но с продолжающимся ростом уровня простатического специфического антигена; 4-я (п = 12) — пациенты, отдавшие предпочтение прицельной биопсии. В ходе процедуры выполняли прицельную биопсию каждого подозритель¬ного, по данным МРТ, очага. Затем проводили «слепую» системную биопсию из 12—14 точек. При этом расположение подозрительных очагов не учитывали, и, таким образом, они могли случайно повторно оказаться в проекции вкола биопсийной иглы.Результаты. При гистологическом исследовании РПЖ выявлен у 71 (74,7 %) из 95 пациентов: в 1-й группе — у 27 (81,8 %) из 33, во 2-й — у 19 (86,4 %) из 22, в 3-й — у 17 (60,7 %) из 28, в 4-й — у 8 (66,7 %) из 12. При этом среди 71 пациента у 21 (29,6 %) РПЖ диагностирован только в материале, полученном при прицельной биопсии, у 9 (12,7 %) — только при системной биопсии, у 41 (57,7 %) больного РПЖ выявлен как при прицельной, так и при системной биопсии. Клинически значимый рак (сумма баллов по шкале Глисона ≥7) после прицельной биопсии выявлен в 84,5 % случаев, после системной — в 70,4 %.Заключение. Применение fusion-биопсии предстательной железы под контролем компьютерной томографии и МРТ повышает эффективность диагностики РПЖ за счет дополнительного выявления клинически значимых опухолей, в том числе у пациентов с невозможностью трансректального доступа

Investigation of blood microcirculation parameters in patients with rheumatic diseases by videocapillaroscopy and laser Doppler flowmetry during cold pressor test

Videocapillaroscopy (VCS) and laser Doppler flowmetry (LDF) are non-invasive methods for evaluating microcirculation parameters. The VCS method is based on a high-speed video recording of capillaries in the nailfold. The recorded video frames are processed using a specialized algorithm to determine the red blood cells velocity. The LDF technique is based on the analysis of the Doppler shift of back-scattered laser radiation from moving red blood cells. In this work, simultaneous measurements of VCS and LDF have been performed in healthy volunteers and rheumatic patient. The study was conducted using a cold pressor test. Changes were recorded in response to cold exposure in rheumatic diseases

LINE-FIELD SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY SYSTEM FOR NEAR INFRARED SPECTRAL REGION

The system for line-field swept-source optical coherence tomography (OCT) for near infrared spectral range is considered. In this connection, for tomograms visualization, frequency of signal acquisition not less than 20 kHz is needed. It is inaccessible for 2D photo sensitive arrays. In order to solve this problem, it has been proposed to use the line array of photo detectors, which frame registration frequency reaches tens of kilohertz. Method. Peculiarity of the method consists in using illumination of an object under investigation by light intensity distribution in the form of line for providing maximum energy efficiency of optical system. In addition, it becomes possible to obtain B-scans without a need in lateral object scanning that increases the rate of formation and imaging of tomograms. Main Results. The OCT optical system using a high-speed array of photodetectors has been developed; aberration analysis has been carried out. Experimental investigations based on Linnik micro interferometer optical scheme has been carried out. Tomograms of different samples have been obtained. Practical Relevance. Тhe obtained results can be accepted as a basis for creation of compact high performance OCT system without lateral mechanical scanning

STUDY OF INK LAYER BY METHOD OF ATTENUATED TOTAL REFLECTANCE SPECTROSCOPY

Subject of Research. Researchresults of thickness distribution of an ink layer smearedon a glass surface are presented. The orange ink which is used as a coloring pigment in writing instrument (highlighter) is selectedasan object of study. Method. Researches were carried out by the method of attenuated total reflectance(ATR) spectroscopy. The spectral setup fitted up on the basis of monochromator MDR-204 was usedin the experiment. The peculiarity of the measurement scheme is the applicationofhigh-resolution camera as a radiation detector and information storage as an images package. Researches allowed receivingexperimental data in the form of ink ATR spectra arrayfor studied areas of layer surface in a given spectral range. Main Results. The estimation of ink layer thickness was done, that gives the possibilityto visualize its distribution over the surface using three-dimensional modeling capabilities. The thickness of the ink layer is not more than 0.12 microns and arithmetic mean of the thickness is0.06 microns. The local areas are observed in an ink distribution, they have a maximum layer thickness (0.07-0.12 microns) or areas with the ink thickness less then 0.03 microns. Variation of the ink layer thicknessbetween the local areas is smooth. Practical Relevance. The proposed measuring scheme, the sequence of registration and processing of experimental data can be used to studyink distribution within the thickness of a surface layer of other materials,for example, in analysis of signs performed by an ink on paper medium in order to identify them in such areas of science as forensic science andstudy of art

STUDY OF SURFACE LAYERS MICROSTRUCTURE FOR PLANT TISSUE BY OPTICAL COHERENCE MICROSCOPY

The surface layers microstructure of biological tissue on the example of plant fruit exocarp was investigated by spectral optical coherence microscopy with tunable wavelength in the 1305 75 nm range and by the method of correlated optical coherence microscopy at the mean wavelength value equal to 940 nm. The experiments were performed for the intact and defect structures, and calculation of the surface profile of exocarp was performed

FABRICATION OF TISSUE-SIMULATIVE PHANTOMS AND CAPILLARIES AND THEIR INVESTIGATION BY OPTICAL COHERENCE TOMOGRAPHY TECHNIQUES

Methods of tissue-simulative phantoms and capillaries fabrication from PVC-plastisol and silicone for application as test-objects in optical coherence tomography (OCT) and skin and capillary emulation are considered. Comparison characteristics of these materials and recommendations for their application are given. Examples of phantoms visualization by optical coherence tomography method are given. Possibility of information using from B-scans for refractive index evaluation is shown

Investigation of blood microcirculation parameters in patients with rheumatic diseases by videocapillaroscopy and laser Doppler flowmetry during cold pressor test

Abstract Videocapillaroscopy (VCS) and laser Doppler flowmetry (LDF) are non-invasive methods for evaluating microcirculation parameters. The VCS method is based on a high-speed video recording of capillaries in the nailfold. The recorded video frames are processed using a specialized algorithm to determine the red blood cells velocity. The LDF technique is based on the analysis of the Doppler shift of back-scattered laser radiation from moving red blood cells. In this work, simultaneous measurements of VCS and LDF have been performed in healthy volunteers and rheumatic patient. The study was conducted using a cold pressor test. Changes were recorded in response to cold exposure in rheumatic diseases