scholarly journals Ultrasound guided biopsy, a gold standard diagnostical test of the prostate cancer

2005 ◽  
Vol 52 (4) ◽  
pp. 23-26 ◽  
Author(s):  
I. Romics
Keyword(s):  
Prostate Cancer ◽  
Gold Standard ◽  
Middle Part ◽  
Time Span ◽  
Targeted Biopsy ◽  
Ultrasound Guided ◽  
New Techniques ◽  
Know How ◽  
Preoperative Antibiotics ◽  
Palpable Nodule

The author discusses preparations for ultrasound guided prostate biopsy, its technique conditions and the process of performing a biopsy. Every author proposes the use of preoperative antibiotics based prophylaxis. Differences may be found in the type, dosage and the time span of preoperative application. For anesthesia mostly lidocaine was proposed, which may be a gel applied in the rectum or used in the form a prostate infiltrate. The widest debate goes on in respect of defining the number of biopsies needed. Recently 8 or rather 10 samples are proposed to be taken. Twelve biopsies do offer an advantage compared to 6 although in case of 8 this isn?t so. According to the site of sample taking the apex, the base and the middle part are proposed. In case of a palpable nodule or any lesion, made visible by TRUS an additional, targeted, biopsy has to be performed. Certain new techniques like the 3D Doppler, contrast, intermittent and others shall also be presented. A repeated biopsy shall be necessary in case of PIN atypia, beyond that the author also discusses other indications for a repeated biopsy. We may expect the occurrence of direct postoperative complications and it is necessary to know how to treat these.

The use of anaesthetic for transrectal ultrasound-guided prostate biopsy

Ultrasound ◽  
2012 ◽  
Vol 20 (2) ◽  
pp. 98-103
Author(s):  
K Jan ◽  
S M Mak ◽  
N Ley ◽  
G Naisby ◽  
D Chadwick
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Local Anaesthetic ◽  
Gold Standard ◽  
Transrectal Ultrasound ◽  
Prostate Cancer Risk ◽  
Complication Rates ◽  
Ultrasound Guided ◽  
National Guidelines ◽  
The Impact

Background Transrectal ultrasound-guided prostate biopsy is the gold standard technique for detecting prostate cancer, undertaken routinely without the use of local anaesthetic (LA) in our institution. Current national guidelines provided by The NHS Prostate Cancer Risk Management Programme and the National Institute for Health and Clinical Excellence recommend and support the use of local anaesthetic injection as the most effective form of pain relief. Methods The primary aim of the study was to assess the impact of the introduction of national guidelines on the patient's pain perception of the procedure. Secondary aims were to compare the complication rates, i.e. bleeding, symptoms of infection and acceptance of a repeat procedure. A quantitative comparative study was performed. After the procedure, pain was evaluated using a questionnaire containing a visual analogue scale. A total of 75 consecutive patients’ prospective, anonymized questionnaire data, from those who were given LA, were compared with data from 75 patients who underwent prostate biopsy before the introduction of local anaesthetic. Data were analysed using two independent samples tests. Results The study findings supported the national clinical guidelines in the routine use of local anaesthetic during transrectal ultrasound-guided prostate biopsy: by demonstrating improvement in pain score, decreased reported discomfort and increased tolerability with no additional significant morbidity or complications. Conclusion The study has informed future policy and protocols by providing evidence based practice. Current working practice has changed to the routine offer of LA and is at present considered the gold standard.

scholarly journals Daily Stereotactic Ultrasound Prostate Targeting: Inter-user Variability

2003 ◽  
Vol 2 (2) ◽  
pp. 161-169 ◽  
Author(s):  
Martin Fuss ◽  
Sean X. Cavanaugh ◽  
Cristina Fuss ◽  
Dennis A. Cheek ◽  
Bill J. Salter
Keyword(s):  
Prostate Cancer ◽  
Gold Standard ◽  
Setup Error ◽  
Radiation Oncologist ◽  
Ultrasound Guided ◽  
Prostate Radiotherapy ◽  
Average Improvement ◽  
The Mean ◽  
Patient Setup ◽  
Planning Ct

We analyzed the inter-user variability of patient setup for prostate radiotherapy using a stereotactic ultrasound-targeting device. Setup variations in 20 prostate cancer patients were analyzed. Users were a radiation oncologist, a medical physicist, four radiation technologists (RTT) and a radiologist. The radiation oncologist, radiologist, physicist and two RTTs were experienced users of the system (>18 months of experience); two RTTs were users new to the system. Gold standard for this analysis was a control CT acquired immediately following ultrasound targeting. For inter-user variability assessments, the radiation oncologist provided a set of axial and sagittal freeze-frames (standard freeze-frames) for virtual targeting by all users. Additionally each user acquired individual freeze-frames for target alignments. We analyzed the range of virtual setups in each patient along the principal room axes based on standard and individual freeze-frames. The magnitude of residual setup error and percentage of setup change for each user was assessed by control CT/planning CT comparison with individual virtual shifts. A total of 184 alignments were analyzed. The range of virtual shifts between users was 2.7±1.4, 3.6±1.1, and 4.4±1.4 mm (mean±SD) in x, y and z-direction for setups based on standard freeze-frames and 3.9±2.6, 6.0±4.7, and 5.4±2.7 mm for setups based on individual freeze-frames. When only virtual shifts of experienced users were analyzed, the mean ranges were reduced by up to 2.4 mm. Average magnitude of initial setup error before ultrasound targeting was 14.3 mm. Average improvement of prostate setup was 63.1±23.4% in experienced and 35.14±37.7% in inexperienced users, respectively (p<0.0001). Only 5 of 184 (2.7%) virtual alignments would have introduced new larger setup errors (mean 3.2 mm, range 0.2 to 9.5 mm) than the magnitude of the initial setup error. We conclude that ultrasound guided treatment setup for patients treated for prostate cancer can be performed with high inter-user consistency and does lead to improved treatment setup in more than 97% of attempted setups. Experienced use is correlated with a reduced range of setups between users and higher degree of setup improvement when compared with users new to the system.

scholarly journals Usefulness of MRI targeted prostate biopsy for detecting clinically significant prostate cancer in men with low prostate-specific antigen levels

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seokhwan Bang ◽  
Jiwoong Yu ◽  
Jae Hoon Chung ◽  
Wan Song ◽  
Minyong Kang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Multivariate Analyses ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Ultrasound Guided ◽  
Detection Rates ◽  
Clinically Significant

AbstractWe aimed to evaluate the detection rates of prostate cancer (PCa) and clinically significant PCa (csPCa) using magnetic resonance imaging-targeted biopsy (MRI-TBx) in men with low prostate-specific antigen (PSA) levels (2.5–4.0 ng/mL). Clinicopathologic data of 5502 men with PSA levels of 2.5–10.0 ng/mL who underwent transrectal ultrasound-guided biopsy (TRUS-Bx) or MRI-TBx were reviewed. Participants were divided into four groups: LP-T [low PSA (2.5–4.0 ng/mL) and TRUS-Bx, n = 2018], LP-M (low PSA and MRI-TBx, n = 186), HP-T [high PSA (4.0–10.0 ng/mL) and TRUS-Bx, n = 2953], and HP-M (high PSA and MRI-TBx, n = 345). The detection rates of PCa and csPCa between groups were compared, and association of biopsy modality with detection of PCa and csPCa in men with low PSA levels were analyzed. The detection rates of PCa (20.0% vs. 38.2%; P < 0.001) and csPCa (11.5% vs. 32.3%; P < 0.001) were higher in the LP-M group than in the LP-T group. Conversely, there were no significant differences in the detection rates of PCa (38.2% vs. 43.2%; P = 0.263) and csPCa (32.3% vs. 39.4%; P = 0.103) between the LP-M and HP-M groups. Multivariate analyses revealed that using MRI-TBx could predict the detection of csPCa (odds ratio 2.872; 95% confidence interval 1.996‒4.132; P < 0.001) in men with low PSA levels. In summary, performing MRI-TBx in men with low PSA levels significantly improved the detection rates of PCa and csPCa as much as that in men with high PSA levels.

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