ultrasound guided biopsy
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Author(s):  
Sarmad Aslam ◽  
Jeffrey Tsang ◽  
Ian Bickle ◽  
Ali Saiepour

Objective: Prostate cancer is the most common male cancer in the UK. In many hospitals, patients are now being referred for a multi parametric (mp) MRI scan of their prostate as part of an evaluation for the presence of prostate cancer, prior to an ultrasound guided biopsy. PI-RADS score of 3 are defined as “equivocal” for the presence of prostate cancer. Thus, a PIRADS three lesion does not confidently determine whether there is significant prostate disease or not. Our aim is to determine the correlation of PIRADS three prostatic lesions with histology proven, clinically significant cancer. Methods: We performed a retrospective review on a cohort of 143 consecutive patients. Each patient underwent a mp-MRI scan of their prostate given a PIRADS score. PIRADS three lesions were analysed further based on histology and categorised into malignant and non-malignant lesions. PSA results and prostatic volume of PIRADS three lesions were also analysed. Results: We identified forty five patients with PIRADS 3 lesions out of 143 patients. Thirty-two patients subsequently underwent trans-rectal/trans-perineal ultrasound guided biopsy. 43% of patients were found to have had a malignant prostatic adenocarcinoma on histology. The remaining 56% had non-malignant findings. Of those with malignant disease, there was a higher median PSA and lower mean prostatic volume. Conclusions: The study confirms that a score of PIRADS three does not accurately differentiate between malignant and non-malignant lesions. Further investigations such as ultrasound-guided prostate biopsy and PSA parameters are required to accurately ascertain the nature of a prostate lesion with PIRADS score 3. Advances in knowledge: An ultrasound-guided prostate biopsy in patients with PIRADS 3 remains of paramount importance when distinguishing malignant versus non-malignant lesions. Multicentre data of MRI findings with PIRADS three scores is required to yield a sample size large enough to carry out statistical analysis.


2021 ◽  
Vol 58 (S1) ◽  
pp. 101-101
Author(s):  
F. Rosati ◽  
M. Roversi ◽  
G. Ferrini ◽  
S. Solfrini ◽  
M. Rossi ◽  
...  

2021 ◽  
pp. ijgc-2021-002995
Author(s):  
Stamatios Petousis ◽  
Sabrina Croce ◽  
Michel Kind ◽  
Chrysoula Margioula-Siarkou ◽  
Guillame Babin ◽  
...  

BackgroundThe pre-operative differential diagnosis between a uterine leiomyoma and a sarcoma can be a challenge. Available diagnostic tools have difficulty distinguishing between the two pathologies.Primary ObjectiveΤo evaluate the possibility of a pre-operative pathological diagnosis of atypical uterine muscle tumors by vaginal ultrasound-guided biopsy (VUGB).Study HypothesisDiagnostic performance of ultrasound-guided biopsy will be capable of differentiating a leiomyoma from a sarcoma with a sensitivity of >90%.Trial DesignA prospective multi-center interventional study will be performed at 10 tertiary French centers. Vaginal ultrasound Doppler examination and pelvic magnetic resonance imaging will be performed before surgery. VUGB will then be performed by a specialist radiologist. The biopsy will be obtained by performing transvaginal ultrasound under local anesthesia with lidocaine using a 16G needle. At least 4–5 specimens will be obtained in order to provide a histopathological diagnosis. All patients included in the study will be operated by laparotomy. All patients included in the study will be followed up for the subsequent 3 years according to their pathological results.Major Inclusion/Exclusion CriteriaAll patients >35 years old diagnosed with a suspicious uterine tumor will be included.Primary EndpointSensitivity of VUGB on pathological diagnosis.Sample SizeConsidering a sensitivity of 90% (H0) as acceptable and a sensitivity of 95% (H1) as excellent, a sample size of 250 evaluable patients will be necessary to achieve 80% statistical power with a 5% type 1 statistical error.Estimated Dates for Completing Accrual and Presenting ResultsAccrual will be completed in December 2024 with results presented in December 2029.Trial RegistrationInstitutional Review Board (Ethic Committee of Paris Ile de France 6) no 2018-A02343-52.


2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Marco Paciotti ◽  
Davide Maffei ◽  
Pier Paolo Avolio ◽  
Vittorio Fasulo ◽  
Nicola Frego ◽  
...  

Author(s):  
Edward M. Lawrence ◽  
Meghan G. Lubner ◽  
Perry J. Pickhardt ◽  
Michael P. Hartung

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Modou Ndiaye ◽  
Mouhamed Jalloh ◽  
Madina Ndoye ◽  
Samba Thiapato Faye ◽  
Saint Charles Nabab Kouka ◽  
...  

Abstract Background Magnetic resonance imaging (MRI)-guided prostate biopsy has a higher sensitivity than the ultrasound-guided biopsy, but its realization requires a dedicated interventional MRI, specific material, which is not available in our context; hence, ultrasound-guided biopsy remains of great interest. Currently, ultrasound-guided biopsy outside of a clinical trial is the gold standard for the diagnosis of prostate cancer. The objective of our work is to evaluate our practice of transrectal ultrasound-guided prostate biopsy using an endorectal probe by describing the technique and evaluating the morbidity and results. Methods This is a descriptive study of ultrasound-guided prostatic biopsies performed over a 2-year period. The parameters studied were frequency of the procedure, age, rectal examination findings, total PSA level, prostate biopsy morbidities and results. Descriptive statistics were performed, and comparison of qualitative variables was made by the Chi-square test with statistical significance set for α < 5% Results Two hundred and thirty-one patients were included over a two-year period. The mean age of our patients was 65 ± 8.2 years. Rectal examination finding was suspicious in 36.9% and the median total PSA was 19.8 ng/ml (0.1-5936 ng/ml). Seventy-seven percent of patients reported their pathology results. Prostatic adenocarcinoma was the most common finding accounting for 53.7% of results. Complications were observed in 16 patients (6.9%) with a predominance of initial hematuria, voiding pain and fever. Conclusion In our series, the cancer detection rate was significant and the complications rate was acceptable at 6.9%.


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