The Influence of Transrectal Multifocal Prostate Biopsy Under Ultrasound Control on the Degree of Infravesical Obstruction in Different Groups of Patients

. Prostate cancer - is a Malignant neoplasm arising from prostatic epithelium. [1] It is well known, that prostate cancer is the most common cancer in men population. Most patients, who underwent a biopsy of prostate, have expressed varying degrees of benign prostatic hyperplasia and, accordingly, symptoms, specific to the disease, including symptoms of the lower urinary (LUTS). [2], Uroflowmetry is a method widely used around the world to assess the degree of severity of infravesical obstruction [3].The aim was to determine the degree of influence of transrectal multifocal biopsy of the prostate under ultrasound control on the degree of infravesical obstruction [4].The study included patients with elevated serum PSA over 4 ng/ml with the volume (Vpr) of prostate from 20 cm³ to 90 cm³, volume of residual urine no more than 50 cm ³. Uroflowmetry was performed with the determination of the volume of residual urine at the primary treatment. At 21 day after transrectal multifocal prostate biopsy under Ultrasound control all patients underwent uroflowmetry. The age of patients ranged from 40 to 70 years. Patients were divided into 3 groups depending on the volume of the prostate gland. The first group consisted of 28 people where prostate volume ranged from 20 cm³ to 40 cm³, in the second group, consisted of 25 persons, prostate volume ranged from 41 cm³ to 60 cm³, and in the third group, consisted of 30 people, prostate volume ranged from 61 cm³ to 90 cm³. The following indicators of urofloumetry were determined as the following: voided volume, max flow rate, average flow, voiding time, flow time, time to max flow, and the volume of residual urine.This study has demonstrated a high risk of complications in patients with prostate volume of more than 60 cm3 caused by infravesical obstruction after prostate biopsy

The diagnostic accuracy and cost-effectiveness of magnetic resonance spectroscopy and enhanced magnetic resonance imaging techniques in aiding the localisation of prostate abnormalities for biopsy : a systematic review and economic evaluation

Peer reviewedPublisher PD

Comparison of transcutaneous ultrasound over the right flank with transrectal ultrasonography in the diagnosis of pregnancy in New Zealand dairy herds : a thesis presented in partial fulfillment of the requirements for the degree of Master of Veterinary Science at Massey University

Application of a 3.5 MHz sector transducer over the right flank allows the rapid and clear visualization of bovine pregnancy (ie: fetus, fetal membranes, fetal fluid and/or placentomes). A total of 1736 cows in ten commercial, pasture-based New Zealand dairy herds were examined for pregnancy by transcutaneous ultrasound across the right flank and transrectal ultrasound between 37 and 198 days of gestation. The gold standard was derived from calving records or examination at slaughter. The overall sensitivity of transrectal ultrasound (96.24%) was markedly higher than flank ultrasound (58.55%) and the overall probability of a correct diagnosis of pregnancy status was also significantly higher (p<0.0001). From 155 days of gestation, however, flank ultrasound represented a more accurate method of pregnancy diagnosis and the probability of a correct diagnosis was significantly higher (p<0.0001) after this gestational age. The gestational age of 225 cows from four Spring-calving dairy herds was determined and ultrasound pregnancy test recorded, to determine possible fetal characteristics able to be visualized via transcutaneous ultrasound over the right flank in order to age pregnancy during mid to late gestation. Linear or quadratic equations and curves were formulated from 60 to 198 days of gestation. The fetal characteristics of thoracic diameter, abdominal diameter or umbilical diameter can be used to age pregnancy from 60 days of gestation. Placentome height and length were not significant in the determination of gestational age

Transrectal Ultrasound Guided Prostate Biopsy Antibiotic Prophylaxis: Standard vs. Augmented Antibiotic Regimens, and the Role for Pre-Biopsy Rectal Swab Cultures

Objectives: To evaluate peri-procedural antibiotic prophylaxis regimens based on pre-procedural rectal swab cultures. To evaluate infection rates between transrectalbiopsy patients receiving FQs alone and those receiving ceftriaxone or gentamicin in addition to FQs.https://jdc.jefferson.edu/patientsafetyposters/1056/thumbnail.jp

Accuracy of elastic fusion biopsy in daily practice: results of a multicenter study of 2115 patients

OBJECTIVES: To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice. METHODS: We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2-4) and random cores (usually 10-14) were carried out, depending on the clinical case and institution habits. The overall and clinically significant prostate cancer detection rates were assessed, evaluating the diagnostic role of additional random biopsies. The cancer detection rate was correlated to multiparametric magnetic resonance imaging features and clinical variables. RESULTS: The mean number of targeted and random cores taken were 3.9 (standard deviation 2.1) and 10.5 (standard deviation 5.0), respectively. The cancer detection rate of Koelis biopsies was 58% for all cancers and 43% for clinically significant prostate cancer. The performance of additional, random cores improved the cancer detection rate of 13% for all cancers (P < 0.001) and 9% for clinically significant prostate cancer (P < 0.001). Prostate cancer was detected in 31%, 66% and 89% of patients with lesions scored as Prostate Imaging Reporting and Data System 3, 4 and 5, respectively. Clinical stage and Prostate Imaging Reporting and Data System score were predictors of prostate cancer detection in multivariate analyses. Prostate-specific antigen was associated with prostate cancer detection only for clinically significant prostate cancer. CONCLUSIONS: Koelis fusion biopsy offers a good cancer detection rate, which is increased in patients with a high Prostate Imaging Reporting and Data System score and clinical stage. The performance of additional, random cores seems unavoidable for correct sampling. In our experience, the Prostate Imaging Reporting and Data System score and clinical stage are predictors of prostate cancer and clinically significant prostate cancer detection; prostate-specific antigen is associated only with clinically significant prostate cancer detection, and a higher number of biopsy cores are not associated with a higher cancer detection rate

The primacy of multiparametric MRI in men with suspected prostate cancer

Background: Multiparametric MRI (mpMRI) became recognised in investigating those with suspected prostate cancer between 2010 and 2012; in the USA, the preventative task force moratorium on PSA screening was a strong catalyst. In a few short years, it has been adopted into daily urological and oncological practice. The pace of clinical uptake, born along by countless papers proclaiming high accuracy in detecting clinically significant prostate cancer, has sparked much debate about the timing of mpMRI within the traditional biopsy-driven clinical pathways. There are strongly held opposing views on using mpMRI as a triage test regarding the need for biopsy and/or guiding the biopsy pattern. Objective: To review the evidence base and present a position paper on the role of mpMRI in the diagnosis and management of prostate cancer. Methods: A subgroup of experts from the ESUR Prostate MRI Working Group conducted literature review and face to face and electronic exchanges to draw up a position statement. Results: This paper considers diagnostic strategies for clinically significant prostate cancer; current national and international guidance; the impact of pre-biopsy mpMRI in detection of clinically significant and clinically insignificant neoplasms; the impact of pre-biopsy mpMRI on biopsy strategies and targeting; the notion of mpMRI within a wider risk evaluation on a patient by patient basis; the problems that beset mpMRI including inter-observer variability. Conclusions: The paper concludes with a set of suggestions for using mpMRI to influence who to biopsy and who not to biopsy at diagnosis. Key Points: • Adopt mpMRI as the first, and primary, investigation in the workup of men with suspected prostate cancer. • PI-RADS assessment categories 1 and 2 have a high negative predictive value in excluding significant disease, and systematic biopsy may be postponed, especially in men with low-risk of disease following additional risk stratification. • PI-RADS assessment category lesions 4 and 5 should be targeted; PI-RADS assessment category lesion 3 may be biopsied as a target, as part of systematic biopsies or may be observed depending on risk stratification

Transrectal ultrasonography of the adrenal glands in donkeys (Equus asinus)

Little information is available for medical imaging in donkeys and no report about adrenal glands ultrasonography can be found in scientific literature. The feasibility of transrectal ultrasonography of the adrenal glands was tested on 30 healthy donkeys using a 10 MHz linear transducer. Mean age of animals was 10.7 ±4.8 years, mean weight 275.0 ±62.9 Kg and mean height 126.7 ±7.1 cm. The left adrenal gland was visualized in all donkeys. The right gland ultrasonography was not feasible in seven animals with a height less than 116 cm. The left gland was visualized as a linear or slightly curved structure, the right gland was most often S-shaped. In both glands, an hypechoic peripheral zone was identified as the cortex with an inner, hyperechoic medulla. The length was 5.49 ±1.90 cm and 5.15 ±1.10 cm for right and left gland, respectively. Right gland whole and medullary thickness were 0.71 ±0.11 cm and 0.24 ±0.09 cm, 0.65 ±0.13 cm and 0.21 ±0.07 cm, 0.56 ±0.17 cm and 0.25 ±0.07 cm for cranial pole, middle point and caudal pole respectively. Left gland whole and medullary thickness were 0.69 ±0.13 cm and 0.25 ±0.09 cm, 0.66 ±0.13 cm and 0.23 ±0.09 cm, 0.57 ±0.15 cm and 0.26 ±0.09 cm for cranial pole, middle point and caudal pole respectively. There was a significant correlation between height and the entire length of the left gland. Ultrasonography of the adrenal glands is a suitable tool for evaluation of both adrenal glands in most of the donkey. The size is a limiting factor for proper visualization of the right gland