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NUO 2909 Three-dimensional transrectal ultrasound: Planimetric volume measurement of the prostatic zones
S57
NEPHRO-UROLOGY
NU02905
NU02908
THE VALUEOF TRU$DEAND PSAIN JNDICATION OF PROSTATIC BIOPSY GUIDE BY US IN PROSTATE CANCER DIAGNOSIS. JACOB SZEJNFELD,MIGUEL SROUGI,SAMI ARAP,GER4LDO FREIRE - PAULISTA MEDICINE SCHOOL - UNlFESP- BRASIL The results of 1115 prostate transretal US guided biopsies are presented, the indications was suspected DR, elevated PSA ( > 4,0 ng) or US examination altered. The biopsies are the experience of 5 years of systematized and prospective study (1992-19%). Fragments were obtained from suspected areas and randomized in the sextants. The positivity for Cancer was obtained for all combination of biopsy indication. The results are presented in the table. INDICATIONS N % DE CA WA) USC-)PSA(+)TR(-) 277 23 893 US(-)PSA(-)TR(+) 53 3 56 US(+)PSA(-)-IR(-) 99 30 30,3 US(+)PSA(?)TR(-) 108 33 30,5 US(-)PSA(+)TR(+) 76 14 18,4 US(+)PSA(-)TR(+) 109 65 59,6 US(+)PSA(?)TR(+) 33 21 63,4 US(+)PSA(+)TR(-) 141 64 45,3 US(+)PSA(+)TR(+) 183 132 72,l REBIOPSY 16 8 50,o PROSTATIC FOSSA 19 9 47,3 The overall positivity for cancer was observed in 36% of the biopsies.The positivity in the first years was higher. In 381 cancer analyzed was observed prevalence of focal involvement.In 25,9% only 1 area was positive and 23,8% present two areas of cancer involvement. CONCLUSIONS: PSA was the most frequent indication for prostatic biopsies. When it was the unique parameter altered there was low positivity for cancer. The associations of positive parameters improves de cancer risk of the biopsy. The systematized studies of prostate provide
Ioteratithl laser coagulation for benign prostatic hyperplosia - role ofuRraaund ln follow up. A. Woiciechowski, E. Keller, T. Jakubczyk, B. Be-nendoRap&i&&a, A. Malewski, Department of Clinical Radiology, Department of Umlogy, Medical School, Warsaw, Poland
earlier detection of prostatecancer.
Purpose: To determine role of trans rectal ultrasound in follow up of patients who underwent ILC. Methods sod materipl: 65 men with lower urinary tract symptoms caused by BPH underwent ILC treatment with indigo 830 diode la& system. 53 patients have already completed 1,3 and 6 months follow up. The study group was assessed prior the treatment The following criteria are evahmted: nrothv rate, post voiding residual volume, prostate volume, changes in the prostate echostructure following the treatment, International prostate Symptoms Score. (IPSS), Quality of Life (QL). Patients were divided in two groups presenting with and without of urinary retention. Results: In the group presenting with urinary retention prostate volume has changed from 5 1,7 & at the initial measurement to 48,5 cc at 6 months, in the remaining group we recorded vohunes of 45,3 cc and 47,9 cc rexpectively. In the group without urinary retention residual urine volume’ decreased from 93 cc init@lly to 65 cc at 6 months. IPSS score decreased from 21.7 initially to 1 I. 1 respectively. QL score decreased from 4.4 initially and remains stable after 3 months 2.6 and 2.8 - 6/12. Conclusion: In one patient we showed cystic lesibn formation within peripheral zone amtainig blood clot and se-veral periurethral small cysts formation were observed around urethra. TRUS allows to exclude any patients with prostate carcinoma which is not followed by the rise of PSA level.
NU02906
NUO 2909
p Guerrero* , or. cnlr y R".
Miguel
A.
Jimener
Maria Gpe. Tahoa&+,
Carte Or.!&irio
A,
Male's ocudies usxng transi+ectal ultrasound methods has bean changzng a lot Of concepts dwdng the last 5 years. The ewgraphics images of different male reproductive syetem allow "0 to make a complete study Of tale organs. rnfertility problems in a couple are due to A so* Of the study of this problem has been the male's part, was not possible to study vas lfmited because it Sd"d vesicle, ducts and deferens, eyacu1atmy only invasive techniques could be used but prostate. not transrecta1 patients could accept this. The "1traso""d study allow us to check if there is a" alteration and the level was located in most of the reproductive male organs at the moment. These could anorma11t1es he litiS diagnostics, calcificfations, cysts or scme congenital defects. In order to achivlereliable data, studies should be mde by people with knowledge on embrilogy, anatomy, and organ's pathology. Some amx!n!alities that cause obstucction are 15% varicoceles and from these almst half present infertility, it is known that the varicoceles k-ises temperature stopping the testicles function, as well as producing a toxic reflux that affects spermatcgenesia. Using ultrasound we can detect varicoceles even if they are at a suhclinic grade, measuring the diameter of the blood vessels and calculating the flux. The Ultrasound is an unbeatable non invasive tool to detect some Of the infertility causes. A trmsrectal ultrasound study helps us in some xnfertility cases to detect porrrrible anatomic mjures. ax-ad to expreoa a more olear opinion 0” the type of action that should be taken. + Teaching, develcpmmt and Ultrasound in Hexico l * "ltrasmography Center
investigate
Center
of
THREE-DIMENSIONAL TRANSRECTAL ULTRASOUND: PLANIMETRIC VOLUME MEASUREMENT OF THE PROSTATIC ZONES Hannes m Andreas Reissigl, Giinther Janetschek, Ferdinand Frau&her, Gemot Helweg and Georg Bartsch, Innsbruck, Austria OBJECTIVES: This study was undertaken to evaluate the efficiacy of three-dimensional transrectal ultrasound to measure the volumes of the the prostatic zones. METHODS: 8 anatomical specimens were investigated by means of three-dimensional transrectal ultrasound (Cornbison 330, Kretztechnik). The volumes of the prostate and the prostatic zones were measured by means of a special planimetric program; the sonographic images and volumetric results were compared to anatomical sections and volumetric results obtained by water displacement measurement. Then the prostatic zones were measured in 45 patients. RESULTS: Planimetric three-dimensional transrectal volume measurement of the prostatic zones proved to be very accurate in the anatomical specimens. In all 45 patients the volumes of the transition zones could be easily measured. The volume of the prostate is mainly determined by the enlarged transition zone, while the volumes of the other zones remains rather constant. CONCLUSIONS: The prostatic zones, their interrelations and in particular the enlargement of the transition zone in benign prostatic hyperplasia can be visualized by means of three-dimensional transrectal ultrasound; furthermore, the size of the prostatic zones can be measured.
NEPHRO-UROLOGY
NU02905
NU02908
THE VALUEOF TRU$DEAND PSAIN JNDICATION OF PROSTATIC BIOPSY GUIDE BY US IN PROSTATE CANCER DIAGNOSIS. JACOB SZEJNFELD,MIGUEL SROUGI,SAMI ARAP,GER4LDO FREIRE - PAULISTA MEDICINE SCHOOL - UNlFESP- BRASIL The results of 1115 prostate transretal US guided biopsies are presented, the indications was suspected DR, elevated PSA ( > 4,0 ng) or US examination altered. The biopsies are the experience of 5 years of systematized and prospective study (1992-19%). Fragments were obtained from suspected areas and randomized in the sextants. The positivity for Cancer was obtained for all combination of biopsy indication. The results are presented in the table. INDICATIONS N % DE CA WA) USC-)PSA(+)TR(-) 277 23 893 US(-)PSA(-)TR(+) 53 3 56 US(+)PSA(-)-IR(-) 99 30 30,3 US(+)PSA(?)TR(-) 108 33 30,5 US(-)PSA(+)TR(+) 76 14 18,4 US(+)PSA(-)TR(+) 109 65 59,6 US(+)PSA(?)TR(+) 33 21 63,4 US(+)PSA(+)TR(-) 141 64 45,3 US(+)PSA(+)TR(+) 183 132 72,l REBIOPSY 16 8 50,o PROSTATIC FOSSA 19 9 47,3 The overall positivity for cancer was observed in 36% of the biopsies.The positivity in the first years was higher. In 381 cancer analyzed was observed prevalence of focal involvement.In 25,9% only 1 area was positive and 23,8% present two areas of cancer involvement. CONCLUSIONS: PSA was the most frequent indication for prostatic biopsies. When it was the unique parameter altered there was low positivity for cancer. The associations of positive parameters improves de cancer risk of the biopsy. The systematized studies of prostate provide
Ioteratithl laser coagulation for benign prostatic hyperplosia - role ofuRraaund ln follow up. A. Woiciechowski, E. Keller, T. Jakubczyk, B. Be-nendoRap&i&&a, A. Malewski, Department of Clinical Radiology, Department of Umlogy, Medical School, Warsaw, Poland
earlier detection of prostatecancer.
Purpose: To determine role of trans rectal ultrasound in follow up of patients who underwent ILC. Methods sod materipl: 65 men with lower urinary tract symptoms caused by BPH underwent ILC treatment with indigo 830 diode la& system. 53 patients have already completed 1,3 and 6 months follow up. The study group was assessed prior the treatment The following criteria are evahmted: nrothv rate, post voiding residual volume, prostate volume, changes in the prostate echostructure following the treatment, International prostate Symptoms Score. (IPSS), Quality of Life (QL). Patients were divided in two groups presenting with and without of urinary retention. Results: In the group presenting with urinary retention prostate volume has changed from 5 1,7 & at the initial measurement to 48,5 cc at 6 months, in the remaining group we recorded vohunes of 45,3 cc and 47,9 cc rexpectively. In the group without urinary retention residual urine volume’ decreased from 93 cc init@lly to 65 cc at 6 months. IPSS score decreased from 21.7 initially to 1 I. 1 respectively. QL score decreased from 4.4 initially and remains stable after 3 months 2.6 and 2.8 - 6/12. Conclusion: In one patient we showed cystic lesibn formation within peripheral zone amtainig blood clot and se-veral periurethral small cysts formation were observed around urethra. TRUS allows to exclude any patients with prostate carcinoma which is not followed by the rise of PSA level.
NU02906
NUO 2909
p Guerrero* , or. cnlr y R".
Miguel
A.
Jimener
Maria Gpe. Tahoa&+,
Carte Or.!&irio
A,
Male's ocudies usxng transi+ectal ultrasound methods has bean changzng a lot Of concepts dwdng the last 5 years. The ewgraphics images of different male reproductive syetem allow "0 to make a complete study Of tale organs. rnfertility problems in a couple are due to A so* Of the study of this problem has been the male's part, was not possible to study vas lfmited because it Sd"d vesicle, ducts and deferens, eyacu1atmy only invasive techniques could be used but prostate. not transrecta1 patients could accept this. The "1traso""d study allow us to check if there is a" alteration and the level was located in most of the reproductive male organs at the moment. These could anorma11t1es he litiS diagnostics, calcificfations, cysts or scme congenital defects. In order to achivlereliable data, studies should be mde by people with knowledge on embrilogy, anatomy, and organ's pathology. Some amx!n!alities that cause obstucction are 15% varicoceles and from these almst half present infertility, it is known that the varicoceles k-ises temperature stopping the testicles function, as well as producing a toxic reflux that affects spermatcgenesia. Using ultrasound we can detect varicoceles even if they are at a suhclinic grade, measuring the diameter of the blood vessels and calculating the flux. The Ultrasound is an unbeatable non invasive tool to detect some Of the infertility causes. A trmsrectal ultrasound study helps us in some xnfertility cases to detect porrrrible anatomic mjures. ax-ad to expreoa a more olear opinion 0” the type of action that should be taken. + Teaching, develcpmmt and Ultrasound in Hexico l * "ltrasmography Center
investigate
Center
of
THREE-DIMENSIONAL TRANSRECTAL ULTRASOUND: PLANIMETRIC VOLUME MEASUREMENT OF THE PROSTATIC ZONES Hannes m Andreas Reissigl, Giinther Janetschek, Ferdinand Frau&her, Gemot Helweg and Georg Bartsch, Innsbruck, Austria OBJECTIVES: This study was undertaken to evaluate the efficiacy of three-dimensional transrectal ultrasound to measure the volumes of the the prostatic zones. METHODS: 8 anatomical specimens were investigated by means of three-dimensional transrectal ultrasound (Cornbison 330, Kretztechnik). The volumes of the prostate and the prostatic zones were measured by means of a special planimetric program; the sonographic images and volumetric results were compared to anatomical sections and volumetric results obtained by water displacement measurement. Then the prostatic zones were measured in 45 patients. RESULTS: Planimetric three-dimensional transrectal volume measurement of the prostatic zones proved to be very accurate in the anatomical specimens. In all 45 patients the volumes of the transition zones could be easily measured. The volume of the prostate is mainly determined by the enlarged transition zone, while the volumes of the other zones remains rather constant. CONCLUSIONS: The prostatic zones, their interrelations and in particular the enlargement of the transition zone in benign prostatic hyperplasia can be visualized by means of three-dimensional transrectal ultrasound; furthermore, the size of the prostatic zones can be measured.