scholarly journals How to Improve TRUS-Guided Target Biopsy following Prostate MRI

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5647
Author(s):  
Byung Kwan Park
Keyword(s):  
Imaging Modality ◽  
Tumor Location ◽  
Lesion Detection ◽  
Imaging Features ◽  
Cognitive Fusion ◽  
Fusion Biopsy ◽  
Know How ◽  
Systematic Biopsy ◽  
Target Biopsy

TRUS is a basic imaging modality when radiologists or urologists perform cognitive fusion or image fusion biopsy. This modality plays the role of the background images to add to an operator’s cognitive function or MRI images. Operators need to know how to make TRUS protocols for lesion detection or targeting. Tumor location, size, and shape on TRUS are different from those on MRI because the scan axis is different. TRUS findings of peripheral or transition tumors are not well known to radiologists and urologists. Moreover, it remains unclear if systematic biopsy is necessary after a tumor is targeted. The purpose of this review is to introduce new TRUS protocols, new imaging features, new biopsy techniques, and to assess the necessity of systematic biopsy for improving biopsy outcomes.

scholarly journals Comparative Effectiveness of Techniques in Targeted Prostate Biopsy

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1449
Author(s):  
Dordaneh Sugano ◽  
Masatomo Kaneko ◽  
Wesley Yip ◽  
Amir H. Lebastchi ◽  
Giovanni E. Cacciamani ◽  
...  
Keyword(s):  
Current Evidence ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Cognitive Fusion ◽  
Fusion Biopsy ◽  
Detection Rates ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Clinically Significant ◽  
High Level

In this review, we evaluated literature regarding different modalities for multiparametric magnetic resonance imaging (mpMRI) and mpMRI-targeted biopsy (TB) for the detection of prostate cancer (PCa). We identified studies evaluating systematic biopsy (SB) and TB in the same patient, thereby allowing each patient to serve as their own control. Although the evidence supports the accuracy of TB, there is still a proportion of clinically significant PCa (csPCa) that is detected only in SB, indicating the importance of maintaining SB in the diagnostic pathway, albeit with additional cost and morbidity. There is a growing subset of data which supports the role of TB alone, which may allow for increased efficiency and decreased complications. We also compared the literature on transrectal (TR) vs. transperineal (TP) TB. Although further high-level evidence is necessary, current evidence supports similar csPCa detection rate for both approaches. We also evaluated various TB techniques such as cognitive fusion biopsy (COG-TB) and in-bore biopsy (IB-TB). COG-TB has comparable detection rates to software fusion, but is operator-dependent and may have reduced accuracy for smaller lesions. IB-TB may allow for greater precision as lesions are directly targeted; however, this is costly and time-consuming, and does not account for MRI-invisible lesions.

scholarly journals New TRUS Techniques and Imaging Features of PI-RADS 4 or 5: Influence on Tumor Targeting

2021 ◽  
Vol 11 ◽  
Author(s):  
Amy Inji Chang ◽  
Byung Kwan Park
Keyword(s):  
Tumor Targeting ◽  
Transrectal Ultrasound ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Prostate Imaging ◽  
Trus Biopsy ◽  
Trus Image ◽  
Systematic Biopsy ◽  
Target Biopsy

PurposeTo determine if the new transrectal ultrasound (TRUS) techniques and imaging features contribute to targeting Prostate Imaging and Reporting and Data System (PI-RADS) 4 or 5.Materials and MethodsBetween December 2018 and February 2020, 115 men underwent cognitive biopsy by radiologist A, who was familiar with the new TRUS findings and biopsy techniques. During the same period, 179 men underwent magnetic resonance imaging–TRUS image fusion or cognitive biopsy by radiologist B, who was unfamiliar with the new biopsy techniques. Prior to biopsy, both radiologists knew MRI findings such as the location, size, and shape of PI-RADS 4 or 5. We recorded how many target biopsies were performed without systematic biopsy and how many of these detected higher Gleason score (GS) than those detected by systematic biopsy. The numbers of biopsy cores were also obtained. Fisher Exact or Mann–Whitney test was used for statistical analysis.ResultsFor PI-RADS 4, target biopsy alone was performed in 0% (0/84) by radiologist A and 0.8% (1/127) by radiologist B (p>0.9999). Target biopsy yielded higher GSs in 57.7% (30/52) by radiologist A and 29.5% (23/78) by radiologist B (p = 0.0019). For PI-RADS 5, target biopsy alone was performed in 29.0% (9/31) by radiologist A and 1.9% (1/52) by radiologist B (p = 0.0004). Target biopsy yielded higher GSs in 50.0% (14/28) by radiologist A and 18.2% (8/44) by radiologist B (p = 0.0079). Radiologist A sampled fewer biopsy cores than radiologist B (p = 0.0008 and 0.0023 for PI-RADS 4 and 5), respectively.ConclusionsPI-RADS 4 or 5 can be more precisely targeted if the new TRUS biopsy techniques are applied.

scholarly journals Role of helical CT and MRI in the evaluation of spinal dysraphism

2017 ◽  
Vol 4 (1) ◽  
pp. 124
Author(s):  
S. Kanagarameswara Kumaran ◽  
P. Chirtrarasan
Keyword(s):  
Statistical Data ◽  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Helical Ct ◽  
Imaging Features ◽  
Occult Spinal Dysraphism ◽  
Medical College ◽  
Ct And Mri

Background: Spinal dysraphism is a complex congenital anomaly involving the spine and spinal cord. Some lesions seldom require imaging. The aim was to study the usefulness of helical CT and MRI in the evaluation of various presentation of spinal dysraphism, to identify, characterize the lesions and its association with other anomalies which helps in giving an accurate diagnosis based on specific imaging findings.Methods: Seventy patients including 33 males and 37 females’ age ranging from 1year to 30 years clinically suspicious for spinal dysraphism were evaluated using helical CT and MRI in the Department of Radiodiagnosis, Government Kilpauk Medical College and Hospital, Chennai, India.Results: Statistical data analyzed based on imaging findings.56 patients were of open spinal dysraphism type and 14 patients were of occult spinal dysraphism. Different imaging features in spinal dysraphism were evaluated to give composite diagnosis for management.Conclusions: Helical CT and MRI are adjuvant in evaluating cases of spinal dysraphism. MRI is excellent in characterizing the soft tissue spinal anomalies of spinal dysraphism helical CT is an excellent imaging modality for characterization of vertebral bony anomalies.

scholarly journals Adrenal imaging: anatomy and pathology (literature review)

2021 ◽  
Vol 67 (3) ◽  
pp. 26-36
Author(s):  
T. A. Korb ◽  
V. Yu. Chernina ◽  
I. A. Blokhin ◽  
O. O. Aleshina ◽  
A. V. Vorontsov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Literature Review ◽  
Imaging Modality ◽  
Magnetic Resonance Tomography ◽  
Lesion Detection ◽  
Dual Energy Ct ◽  
Emission Computed Tomography ◽  
Imaging Features ◽  
Adrenal Imaging

This literature review focuses on the normal adrenal gland anatomy and typical imaging features necessary to evaluate benign and malignant lesions. In particular, adenoma, pheochromocytoma, metastases and adrenocortical carcinoma were discussed as some of the most common lesions. For this purpose, a review of relevant local and international literature sources up to January 2021 was conducted.In many cases, adrenal incidentalomas have distinctive features allowing characterization using noninvasive methods. It is possible to suspect a malignant nature and promptly refer the patient for the necessary invasive examinations in some cases. ­Computed tomography, especially with intravenous contrast enhancement, is the primary imaging modality because it enables differential diagnosis. Magnetic resonance tomography remains a sensitive method in lesion detection and follow-up but is not very specific for determining the malignant potential. Positron emission computed tomography also remains an additional method and is used mainly for differential diagnosis of malignant tumors, detecting metastases and recurrences after surgical treatment. Ultrasound has a limited role but is nevertheless of great importance in the pediatric population, especially newborns. Promising techniques such as radiomics and dual-energy CT can expand imaging capabilities and improve diagnostic accuracy.Because adrenal lesions are often incidentally detected by imaging performed for other reasons, it is vital to interpret such findings correctly. This review should give the reader a broad overview of how different imaging modalities can evaluate adrenal pathology and guide radiologists and clinicians.

scholarly journals New Biopsy Techniques and Imaging Features of Transrectal Ultrasound for Targeting PI-RADS 4 and 5 Lesions

2020 ◽  
Vol 9 (2) ◽  
pp. 530 ◽  
Author(s):  
Byung Kwan Park ◽  
Sung Yoon Park
Keyword(s):  
Cancer Detection ◽  
Transrectal Ultrasound ◽  
Lesion Detection ◽  
Magnetic Resonance Imaging Examination ◽  
Imaging Features ◽  
Targeted Biopsy ◽  
New Techniques ◽  
Transition Zones ◽  
Clinically Significant ◽  
Systematic Biopsy

Purpose: To introduce new biopsy techniques and imaging features of transrectal ultrasound (TRUS) for targeting Prostate Imaging Reporting and Data System (PI-RADS) 4 and 5 lesions Methods: TRUS-guided targeted and/or systematic biopsies were performed in 432 men with PI-RADS 4 and 5 lesions following magnetic resonance imaging examination. A TRUS operator who was familiar with the new techniques and imaging features performed lesion detection. Overall and significant cancer detection rates (CDRs) were compared among the men with PI-RADS 4 and 5 lesions. The CDRs in the peripheral and transition zones were compared. Additionally, we assessed whether targeted or systematic biopsies contributed to cancer detection. The standard reference was a biopsy examination. Results: The overall CDRs in the men with PI-RADS 4 and 5 lesions were 49.5% (139/281) and 74.8% (113/151) (p < 0.0001); significant CDRs were 33.1% (93/281) and 58.3% (88/151) (p < 0.0001); and CDRs in the peripheral and transition zones were 53.6% (187/349) and 78.3% (65/83) (p < 0.0001), respectively. Of the 139 men with clinically significant cancer PI-RADS 4 lesions, 107 (77.0%) were diagnosed by targeted biopsy, 5 (3.6%) by systematic biopsy, and 27 (19.4%) by both. Of the 113 men with clinically significant cancer PI-RADS 5 lesions, 97 (85.8%) were diagnosed by targeted biopsy, 3 (2.7%) by systematic biopsy, and 13 (11.5%) by both. Conclusions: Most PI-RADS 4 and 5 lesions can be targeted with TRUS if the new techniques and imaging features are applied.

scholarly journals Role of imaging (MDCT) in ocular and orbital lesions

2017 ◽  
Vol 13 (3) ◽  
pp. 24-36
Author(s):  
Pratima Kumari Shah ◽  
RK Rauniyar ◽  
MK Gupta ◽  
BP Badhu
Keyword(s):  
Computed Tomography ◽  
Imaging Modality ◽  
Final Diagnosis ◽  
Cross Sectional Study ◽  
Response To Treatment ◽  
Imaging Features ◽  
Cross Sectional ◽  
Traumatic Lesion ◽  
Orbital Lesions

Background: Radiological imaging is still important to diagnose ocular and orbital abnormalities. Computed tomography is the first-line imaging modality for orbital imaging in the acute setting with magnetic resonance imaging playing an important secondary role.Objective: To assess the role of multidectector computed tomography (MDCT) in diagnosis of ocular and orbital lesions. To describe the imaging features of various orbital and ocular lesions on MDCT.Methods: A prospective cross-sectional study was conducted on 50 patients in B.P. Koirala Institute of Health Sciences, over the period of one year (from July 2013 to June 2014). All the patients with clinical suspicion of ocular and orbital lesions, referred from the ophthalmology department for CT scan were included in this study.Results: Out of 50 cases 4 were traumatic and 46 were non traumatic cases. Retinoblastoma was most common non traumatic lesion in our study. We compared MDCT diagnosis and final diagnosis which was based on histopathology/ per operative finding, FNAC, clinical response to treatment, supportive laboratory (biochemical/ microbiological) findings and supportive findings on other radiological investigations (USG and MRI). The sensitivity of MDCT in diagnosing ocular and orbit lesions was 95.65%.Conclusion: MDCT has important role in characterization and diagnosis of the lesions, surgical planning and follow up of patient with various ocular and orbital pathologies. MDCT is better for evaluation of bones and detection of calcifications and to discern the location, extent and configuration of the lesions. Therefore MDCT is an ideal radiological method for evaluation of various ocular and orbital lesions. Health Renaissance 2015;13 (3): 24-36

The Expanding Role of Echocardiography in Interventional Cardiology

2010 ◽  
Vol 6 (2) ◽  
pp. 71 ◽  
Author(s):  
Lindsay A Smith ◽  
Amit Bhan ◽  
Mark J Monaghan ◽  
◽  
◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Imaging Modality ◽  
Interventional Cardiology ◽  
Design And Technology ◽  
Team Approach ◽  
Medical Problems ◽  
Multidisciplinary Team Approach ◽  
Case Selection ◽  
Optimal Imaging

Echocardiography provides excellent realtime imaging of the heart, making it the imaging modality of choice immediately before, during and after cardiac interventional procedures. It helps to guide case selection and execution of the intervention, evaluates the effects of the intervention and enables early detection of complications. Advances in the design and technology of medical devices and delivery systems, coupled with demand for alternative non-surgical therapies for common medical problems, have led to an increase in the volume, variety and complexity of non-coronary cardiac interventional procedures performed. Many of these procedures require a multidisciplinary team approach and demand optimal imaging to ensure successful outcomes. The aim of this article is to review the expanding role of echocardiography in non-coronary interventional cardiology in adults.

Preparing the Child for Productive Life

IJOHMN ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. 16
Author(s):  
Stella Baindu Fortune Fortune
Keyword(s):  
Learner Control ◽  
Counseling Services ◽  
Guidance And Counseling ◽  
School Life ◽  
Productive Life ◽  
Know How ◽  
Physical Conditions ◽  
The Family ◽  
Genetic Endowment

The nature of children’s development is greatly influenced by the environmental conditions in which they are brought up. The amount of social stimulation which they receive is of particular importance, and even if physical conditions are adequate, an unstimulating environment which provides with little opportunity or need to experiment or solve problems will result in low level of achievement. Perhaps the most important aspect of the child’s social development is beyond the reach of the teacher. For the first very important aspect of the child’s development lies in the home. Genetic endowment and cultural level of the family, coupled with the actual physical conditions of the home will have decisive effect on the child’s development and will continue to influence him throughout his school life. These factors are inaccessible to be influenced by the teacher but it is as well for him to have them in mind in his dealings with pupils. In addition, he will need to know how he may most effectively change his pupils along the lives he considers to be the most appropriate. That is, he will seek out the most efficient ways of getting pupils learn for productive life in future. The topic under review will be approached from various fronts which include; The Sociological and Philosophical models; role of the school; Learners’ responsibility; role of the teacher; discipline and learner control; role of the parent; guidance and counseling services and conclusion.

Juvenile xanthogranuloma of the subdural spaces mimicking chronic hematoma with positive FDG uptake on PET: case report

2020 ◽  
Vol 26 (4) ◽  
pp. 449-453
Author(s):  
Jacob A. Kahn ◽  
Jeffrey T. Waltz ◽  
Ramin M. Eskandari ◽  
Cynthia T. Welsh ◽  
Michael U. Antonucci
Keyword(s):  
Potential Role ◽  
Response To Treatment ◽  
Juvenile Xanthogranuloma ◽  
Imaging Features ◽  
Limited Information ◽  
Advanced Imaging ◽  
Systemic Involvement ◽  
The Central Nervous System ◽  
Infancy And Early Childhood

The authors report an unusual presentation of juvenile xanthogranuloma (JXG), a non–Langerhans cell histiocytosis of infancy and early childhood. This entity typically presents as a cutaneous head or neck nodule but can manifest with more systemic involvement including in the central nervous system. However, currently there is limited information regarding specific imaging features differentiating JXG from other neuropathological entities, with diagnosis typically made only after tissue sampling. The authors reviewed the initial images of a young patient with shunt-treated hydrocephalus and enlarging, chronic, extraaxial processes presumed to reflect subdural collections from overshunting, and they examine the operative discovery of a mass lesion that was pathologically proven to be JXG. Their results incorporate the important associated histological and advanced imaging features, including previously unreported metabolic activity on FDG PET. Ultimately, the case underscores the need to consider JXG in differential diagnoses of pediatric intracranial masses and highlights the potential role of PET in the initial diagnosis and response to treatment.

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