Ultrasonography of renal masses using contrast pulse sequence imaging : a pilot study

Background and Purpose: The use of contrast-enhanced ultrasonography for imaging of renal masses was first described in 1994. Since then, many new techniques for visualization of the effect of microbubble contrast agents have been developed. In this pilot study, a small number of patients was investigated with contrast pulse sequence imaging (CPS), and the characteristics of this perfusion imaging technique were evaluated subjectively and judged against the clinical diagnosis and histology findings when available. The purpose of this pilot study was to describe CPS imaging in several cases. Patients and Methods: Eighteen patients with 20 previously identified renal masses were examined with CPS. Perfusion imaging was compared with clinical diagnosis and with histologic findings when available. Results: Nineteen masses were visible. Various enhancement patterns could be observed, and interpretations of CPS characteristics are described. In carcinomas, inhomogeneous enhancement patterns were observed, and areas without enhancement inside the inhomogeneous lesions corresponded to necrotic areas in histologic specimens. All simple cysts and complex benign cysts showed absence of enhancement inside or in the wall of the lesion and a regular shape. Conclusion: To our knowledge, this is the first study in which the characteristics of CPS imaging of renal masses have been related to clinical diagnoses and histologic features. From the results of this pilot project, we conclude that CPS is a promising technique to determine perfusion patterns in the kidney

Avances en el diagnostico ecografico del cancer de prostate

OBJETIVO: La biopsia guiada por ecografía posee un papel primordial en el diagnóstico del cáncer de próstata. Diversos protocolos de biopsia prostática guiada mediante ultrasonidos se han diseño en un intento de mejorar el diagnóstico del cáncer de próstata. La incorporación de los contrastes vasculares permite identificar aquellas zonas hipervasculares compatibles con cáncer, mientras que los nuevos modos de ecografía permiten incrementar y diferenciar la señal producida por el contraste, separándola de la señal reflejada por el tejido normal. MÉTODO: Revisión no estructurada de la literatura sobre la utilidad de los diversos modos y tipos de ecografía en dirigir la biopsia prostática

Contrast-enhanced ultrasonography in the follow-up of cryoablation of renal tumours : a feasibility study

OBJECTIVE To determine whether evaluating perfusion patterns with contrast-enhanced ultrasonography using contrast-pulse sequence imaging (CPS; a new imaging method that enables selective visualization of perfusion) is possible at different times after cryoablation of renal tumours, and to describe the characteristics of CPS in a small group of patients. PATIENTS AND METHODS The efficacy of renal cryoablation is mainly judged using imaging. Seven randomly selected patients, each at a different time after laparoscopically assisted cryoablation of a renal tumour, were investigated with CPS and a microbubble-contrast agent. The perfusion characteristics in the lesions were scored by two investigators and described, and the lesions were measured. RESULTS In the seven patients treated with cryoablation for small renal tumours, eight CPS studies were performed. Five lesions showed no enhancement and one lesion, investigated 18 months after treatment was not recognized. In one patient, no enhancement was seen after 1 month but 7 months later, there were minimal contrast signals inside the treated area. The lesions could be measured with a mean standard deviation of 1.1 mm and a mean difference between the two investigators of 0.7 mm. CONCLUSION Our first experiences with CPS imaging for the follow-up of renal cryoablation show that this technique can be used to characterize perfusion defects at different times after cryoablation

Avances en el diagnostico ecografico del cancer de prostate

OBJETIVO: La biopsia guiada por ecografía posee un papel primordial en el diagnóstico del cáncer de próstata. Diversos protocolos de biopsia prostática guiada mediante ultrasonidos se han diseño en un intento de mejorar el diagnóstico del cáncer de próstata. La incorporación de los contrastes vasculares permite identificar aquellas zonas hipervasculares compatibles con cáncer, mientras que los nuevos modos de ecografía permiten incrementar y diferenciar la señal producida por el contraste, separándola de la señal reflejada por el tejido normal. MÉTODO: Revisión no estructurada de la literatura sobre la utilidad de los diversos modos y tipos de ecografía en dirigir la biopsia prostática

Cryotherapy for renal-cell cancer : diagnosis, treatment, and contrast-enhanced ultrasonography for follow-up

Cryotherapy is a curative treatment option for patients with small

Nephron-sparing surgery and percutaneous biopsies in renal-cell carcinoma : a global impression among endourologists

Background and Purpose: On the one hand, nephron-sparing surgery (NSS) in small renal tumors is a safe and effective alternative to radical nephrectomy. On the other hand, the role of preoperative percutaneous needle biopsies (PNB) remains controversial. The purpose of this study was to evaluate the global current use of NSS in the treatment of renal-cell carcinoma (RCC) and the use of PNB among endourologists. Materials and Methods: One thousand questionnaires were distributed during the 23rd World Congress of Endourology and SWL. Six questions regarding NSS and two questions regarding PNB were presented. Two hundred twenty-two questionnaires were returned. Results: Of the respondents, 86.6% perform NSS for small renal tumors, whereas 13.4% perform only radical nephrectomies; 7.5% will consider NSS only in patients with a solitary kidney, and 0.5% will never consider NSS. The techniques for NSS, in descending order of preference, are partial nephrectomy, enucleation, cryoablation, radiofrequency ablation, and high-intensity focused ultrasound. The mean and maximum diameter of the tumor in patients with a normal contralateral kidney for which the urologists perform NSS is 4.0 cm. For a centrally located tumor, NSS is an option for 27.2% of the respondents. Regarding PNB in patients with suspicion of RCC, 55.9% of respondents never obtain renal biopsies in the preoperative assessment and 41.8% obtain them only in rare cases. The majority (90%) prefer histologic over cytologic biopsies. Conclusions: Nephron-sparing surgery is evolving to a global worldwide standard treatment for small renal tumors. Percutaneous needle biopsy remains a highly debated procedure

Optimizing prostate cancer detection : 8 versus 12-core biopsy protocol

Purpose We compared prostate cancer detection rates achieved using an 8 and 12-core biopsy protocol in a clinical population to determine the significance of additional transition zone sampling on repeat biopsy. Materials and Methods Between September 2004 and September 2007, 269 eligible patients with a clinical suspicion of prostate cancer referred to our department were randomized to an 8-core lateral (group 1) or a 12-core lateral and parasagittal (group 2) transrectal ultrasound guided prostate biopsy protocol. Study inclusion criteria were age dependent increased serum prostate specific antigen (1.25 ng/ml or greater at ages less than 50 years, 1.75 or greater at ages 50 to less than 60 years, 2.25 or greater at ages 60 to less than 70 years and 3.25 or greater at ages 70 years or greater), positive digital rectal examination and/or suspicious transrectal ultrasound. After negative first round biopsy patients underwent 12-core biopsy, including 4 transition zone cores. Results Nine patients were excluded from analysis because of protocol violation or they did not complete the whole biopsy procedure due to discomfort. The cancer detection rate in groups 1 and 2 did not differ significantly (34.1% or 45 of 132 patients and 38.3% or 49 of 128, respectively, p = 0.48). Detected cancer median Gleason scores were similar in the groups. Of 109 patients who underwent repeat biopsy prostate cancer was detected in 20 (14.4%), of whom 9 had positive cores from the transition zone and 6 had positive biopsies only from the transition zone. Conclusions There are no statistically significant differences in the prostate cancer detection rate between 8 and 12-core prostate biopsy protocols. Transition zone biopsies contribute to prostate cancer detection in a repeat biopsy protocol

Contrast-enhanced ultrasound and prostate cancer; a multicentre European research coordination project

Context Contrast-enhanced ultrasound is a real-time imaging technique with the capability of visualizing perfusion patterns. Since tumour growth is associated with changes in vascularisation, this modality is under research for imaging of various tumour types. Studies have shown promising results for the diagnosis of prostate cancer for various imaging techniques; however, the exact value of each technique is still unclear. Objective To determine the value of contrast-enhanced ultrasound (CEUS) in the detection, localisation, and follow-up of treatment for prostate cancer. Evidence acquisition In the period 2002–2006, research in four European centres regarding CEUS of the prostate was coordinated in a combined program. This paper describes and combines the results of these studies. Evidence synthesis Various techniques were developed and researched during the period of this program. Studies showed that prostate cancer could be visualized and localized in up to 78%. Visualization of the tumour enabled better detection; targeted biopsies lead to fewer biopsies per session without loss of detection rate. A combined approach offered the highest detection rate. CEUS could be used to visualize the effects of high-intensity focussed ultrasound and hormonal therapy for prostate cancer with success, and identified patients with an early relapse. Unfortunately, pretreatment evaluation could not identify the nonresponders beforehand. Conclusions This research project was a first step towards routine use of CEUS in the clinical detection and follow-up of prostate cancer; and new combined studies are initiated

Thymus algeriensis and Thymus fontanesii: Chemical Composition, In Vivo Antiinflammatory, Pain Killing and Antipyretic Activities: A Comprehensive Comparison

This study aimed to investigate the chemical composition, and evaluate the antioxidant, anti-inflammatory, anti-pyretic, and the analgesic properties of methanol extracts from the leaves of Thymus algeriensis and Thymus fontanesii (Lamiaceae). Thirty-five secondary metabolites were characterized in both extracts using HPLC-PDA-ESI-MS/MS. Phenolic acids, mainly rosmarinic acid and its derivatives, dominated the T. algeriensis extract, while the phenolic diterpene carnosol and the methylated flavonoid salvigenin, prevailed in T. fontanesii extract. Molecular docking study was carried out to estimate the anti-inflammatory potential and the binding affinities of some individual secondary metabolites from both extracts to the main enzymes involved in the inflammation pathway. In vitro enzyme inhibitory assays and in vivo assays were used to investigate the antioxidant and anti-inflammatory activities of the extracts. Results revealed that both studied Thymus species exhibited antioxidant, anti-inflammatory, analgesic, and antipyretic effects. They showed to be a more potent antioxidant than ascorbic acid and more selective against cyclooxygenase (COX-2) than diclofenac and indomethacin. Relatively, the T. fontanesii extract was more potent as COX-2 inhibitor than T. algeriensis. In conclusion, Thymus algeriensis and Thymus fontanesii may be interesting candidates for the treatment of inflammation and oxidative stress-related disorders