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Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Jocelyn A. Luongo, Boris Shapiro, Orlando A. Ortiz, Douglas S. Katz
Both CT and ultrasound are used for diagnosis, with ultrasound also having therapeutic utility in transrectal drainage. Abscesses can occur anywhere in the prostate, although they are usually centered away from the midline. Findings on transabdominal and/or transrectal ultrasound include focal hypoechoic or anechoic masses, with thickened or irregular walls, septations, and internal echoes. On CT, findings include an enlarged gland containing multiple well-demarcated, non-enhancing fluid collections within the gland and/or periprostatic tissues. These collections may be multi-septated or demonstrate enhancing rims [3,27,28,31].
Urological cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Transrectal ultrasound is used routinely to provide real-time images and is used to direct needle biopsy towards the suspicious areas of the gland and also in brachytherapy to direct accurate placement of radioactive sources. Doppler flow studies can give even greater detail of the internal structure of the gland and highlight abnormal areas.
Management of deep infiltrative endometriosis (DIE) causing gynecological morbidity: A colorectal surgeon's perspective
Published in Seema Chopra, Endometriosis, 2020
The utility of transrectal ultrasound (TRUS) has been well described [26]. It scores over MRI in the diagnosis of rectal involvement [27]. In a large series, reported sensitivity and specificity of TRUS was 97% and 96%, respectively. TRUS offers the same advantages as TVS, that is, estimation of precise depth of involvement of the bowel wall layers and number of lesions and their location. It has an added advantage that the distance of the lesion from the anal verge can be estimated [26]. However, TRUS can be painful and uncomfortable, especially when assessing lesions near the rectosigmoid. This may necessitate general anesthesia in a few patients. In addition, TRUS is infrequently available and difficult to access for most gynecologists. Therefore, TRUS is supplanted by TVS in most instances.
A multicenter retrospective study on evaluation of predicative factors for positive biopsy of prostate cancer in real-world setting
Published in Current Medical Research and Opinion, 2021
Ben Xu, Gonghui Li, Chuize Kong, Ming Chen, Bin Hu, Qing Jiang, Ningchen Li, Liqun Zhou
Further, we evaluated the proportion of biopsy positive patients in various subgroups such as patients undergoing biopsy by various approaches, PSA subgroup and frequency of puncture subgroup. Highest rate of positive biopsy (>50%) was observed in patients undergoing TPB (62.5), patients with PSA > 10 (60.57%) and in patients receiving <10 puncture (52.2%). Majority (90.6%) of the patients included in our study received transrectal ultrasound (TRUS)-guided biopsy, the widely accepted approach. However, the positive rate of biopsy was higher with TPB compared with TRUS approach (62.5% vs. 47.8%). This may be probably due to the false-negative incidence of up to 46% with TRUS biopsy14,33. TPB has been considered as a sensitive technique with high detection rate and alternative approach to TRUS biopsy34.
Consecutive transperineal prostatic template biopsies employing cognitive and systematic approach: a single center study
Published in The Aging Male, 2020
Zubair Bhat, Arshad Bhat, Wasim Mahmalji
The study is registered as an audit in the Medway NHS Foundation trust. We retrospectively reviewed consecutive patients who underwent transperineal template prostatic biopsies from January 2016 till December 2018. This included patients on active surveillance, negative transrectal ultrasonography (TRUS) biopsies with persistently raised prostate-specific antigen (PSA)/abnormal digital rectal examination and biopsy in naïve patients. Systematic mapping biopsies were taken from both the lobes and cognitive target biopsies consisted of four additional target biopsies in addition to systematic prostatic sampling. Biopsies were performed in the operating theatre under general anesthesia with the patient in the dorsal lithotomy position. All men received perioperative antibiotics and the antibiotics were continued postoperatively for 3 days. Using transrectal ultrasound probe, the prostate gland examined and prostate volume was determined. The suspicious MRI lesions cognitively projected according to the MRI study for cognitive fusion biopsies.
End-fire versus side-fire: a randomized controlled study of transrectal ultrasound guided biopsies for prostate cancer detection
Published in Scandinavian Journal of Urology, 2020
Margaretha A. van der Slot, Joost A. P. Leijte, Deric K. E. van der Schoot, Eric H. G. M. Oomens, Stijn Roemeling
The most common indication for performing prostate biopsy is the suspicion of prostate cancer, mostly based on an elevated PSA level and/or an abnormal DRE. Currently, prostate biopsies remain the standard of care to assess the presence, type and extension of prostate cancer. Transrectal ultrasound guided prostate biopsy is one of the standard of care for taking biopsies [1]. Biopsies can be performed using either an end-fire or side-fire biopsy technique. A side-fire probe has two planes of view, of which the sagittal view is used to visualize the needle tract for biopsy. The end fire probe has a single plane on the tip of the probe, biopsy can be performed in all sections, transverse, sagittal and oblique plane, by turning and rotating the probe (Figure 1) [2]. A retrospective study of Ching et al., observed a higher prostate cancer detection rate using the end-fire technique [3]. Another retrospective study of Raber et al., showed no significant difference between the both techniques in detection rates of prostate cancer [4]. The aim of this study was to evaluate the prostate cancer detection rate of the end-fire and side-fire techniques in a prospective randomized controlled trial.