Color doppler-guided prostate biopsies in 591 patients with an elevated serum psa level: Impact on gleason score for nonpalpable lesions

Cornud, F.; Belin, X.; Piron, Damien; Chrétien, Yves; Flam, T.; Casanova, J. M.; Hélénon, O.; Méjean, A.; Thiounn, Nicolas; Moreau, Jean-François

doi:10.1016/s0090-4295(96)00632-2

Cited by 82 publications

(37 citation statements)

References 21 publications

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“…However, CD presents certain limitations as prostate cancer is not particularly vascularized [19]; there are significant similarities between inflammatory and neoplastic changes and both pathologies are characterized by hypervascularization at CD [19]. Some studies suggest that CD improves the detection of glandular areas with a high Gleason score [22] and that blood flow detectable at CD in tumors of the prostate and the adjacent capsule correlates with the grading and staging [23]. Power Doppler (PD) is considered sufficiently sensitive in the detection of slow venous flow in neoplastic lesions of the (894) prostate and more sensitive than CD in the detection of blood flow in the new tumor vessels [24].…”

Section: Discussionmentioning

confidence: 99%

Real-time elastography in the diagnosis of prostate tumor

Ferrari

Scorzelli

Megliola

et al. 2009

Journal of Ultrasound

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KEYWORDSProstate cancer; Ultrasonography; Real-time elastography.Abstract Aim: To assess the diagnostic gain of transrectal real-time elastography (RTE) compared to transrectal B-mode ultrasonography (US) in the detection of tumors in patients suspected of having prostate cancer. Materials and methods: Eighty-four patients suspected of having prostate cancer on the basis of clinical and biochemical evaluation underwent transrectal US, RTE and transperineal prostate biopsy. Results: Biopsy was considered the gold standard. Analysis related to the total number of patients showed a B-mode US sensitivity of 56%, specificity 80%, positive predictive value (PPV) 70% and negative predictive value (NPV) 67%. Analysis related to the total number of biopsy cores showed sensitivity 33%, specificity 92%, PPV 69% and NPV 73%. In the patientrelated analysis, RTE sensitivity was 51%, specificity 75%, PPV 64% and NPV 64%, while the core-related analysis showed sensitivity 36%, specificity 93%, PPV 72% and NPV 74%. Comparison of B-mode US and RTE diagnostic accuracy in the detection of tumors located in the peripheral zone of the prostate gland showed a significant difference. Analysis related to the total number of biopsy cores harvested in the peripheral zone of the prostate gland showed a B-mode US sensitivity of 48%, specificity 81%, PPV 75% and NPV 58%, whereas RTE achieved the following values: sensitivity 66%, specificity 78%, PPV 77%, and NPV 67%. Conclusions: RTE is a valid addition to B-mode US, and RTE reached a higher accuracy than Bmode US in the evaluation of the peripheral zone of the prostate gland and in the selection of appropriate biopsy sites.Sommario Scopo: Verificare il guadagno diagnostico dell'elastosonografia transrettale realtime (RTE) rispetto alla ecografia transrettale B-mode nel rilievo del tumore prostatico in una popolazione di pazienti con sospetto di neoplasia. Materiali e metodi: Ottantaquattro pazienti con sospetto clinico-laboratoristico di tumore prostatico sono stati valutati mediante ecografia transrettale, elastosonografia e biopsia transperineale. Risultati: L'esame bioptico è stato considerato lo standard di riferimento. Nella valutazione per paziente, la sensibilità dell'ecografia B-mode è stata del 56%; la specificità dell'80%; il valore predittivo positivo (VPP) del 70%, il valore predittivo negativo (VPN) del 67%. Nella valutazione sul totale dei prelievi bioptici la sensibilità è stata del 33%, la specificità del 92%, il VPP del 69%, il VPN del 73%. La RTE ha ottenuto i seguenti risultati nella valutazione per paziente: sensibilità 51%, specificità 75%, VPP 64% e VPN 64%. Nella valutazione sul totale dei prelievi bioptici: sensibilità 36%, specificità 93%, VPP 72%, VPN 74%. Confrontando i valori di accuratezza dell'ecografia B-mode e della RTE per i tumori della zona periferica, è stata trovata una differenza significativa. Nella valutazione sul totale dei prelievi bioptici della zona periferica la sensibilità dell'ecografia B-mode è stata del 48%, la specificità dell'81%, il VPP d...

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Section: Discussionmentioning

confidence: 99%

Real-time elastography in the diagnosis of prostate tumor

Ferrari

Scorzelli

Megliola

et al. 2009

Journal of Ultrasound

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“…Residual urine has been suggested as the cause of urinary tract infection. [14,15] Similarly, recurrent urinary tract infection has been reported to be caused by residual urine in the elderly population and in girls. [6,16,17] Klarskov et al demonstrated that PVR increased the risk of acute urinary retention 3.6 times.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Post-Void Residual Urine in Patients with Lower Urinary Tract Symptoms

Türk

Ün

2017

EJMO

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Objectives: Benign prostatic hyperplasia is considered one of the most important health issues seen in older males, and is characterized by clinical lower urinary tract symptoms (LUTS). A high volume of residual urine can be seen in both organic obstructions as well as bladder dysfunctions. In this study, the primary objective was to evaluate clinical and lab results that can be used as predictive factors in significantly high residual urine volume/urinary retention. Methods: A total of 491 patients over the age of 40 years who presented at the urology clinic with LUTS complaints from September 2015 to December 2016 were included in the study. Our routine evaluation protocol, which consists of patient history, physical examination, prostate-specific antigen test, urinalysis, uroflowmetry, and post-void residual volume assessment, was used to evaluate all the patients included in the study. Results: In univariate analysis, body mass index, peak flow rate (Qmax), and prostate volume were found to be significant predictive factors of post void residual (PVR) urine (p=0.001, <0.0001, and <0.001, respectively). Multivariate analysis also confirmed these as significant predictive factors of PVR (p=0.013, <0.0001, and 0.001, respectively). Conclusion: Uroflowmetry is a very important tool in the assessment and follow-up of patients with LUTS. As a complementary action, PVR urine volume should also be measured. Residual urine can be significant in patients Qmax of less than 10.1 mL/second and with large prostate volume (>40 cc).

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“…Less experienced and more experienced investigators will develop greater con®dence with FDU. Cornud et al 45 compared TRUS and FDU in the detection of prostate cancer and found a sensitivity of 90% and 78% respectively and a speci®city of 46% and 80% respectively. Non palpable cancers with hypervascularized lesions showed a signi®cant (P`0.001) higher Gleason score (6.5 AE 1.1) than non-hypervascularized lesions (Gleason 5.5 AE 0.9).…”

Section: Doppler Imagingmentioning

confidence: 99%

Transrectal ultrasound imaging of the prostate: review and perspectives of recent developments

Sedelaar

Rosette

Beerlage

et al. 1999

Prostate Cancer Prostatic Dis

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We present a critical review of the recent literature and discuss the development and prospective view of the evaluations of transrectal ultrasound with regard to prostate malignancy. We illustrate this with personal experiences. Material and Methods: Based on a critical evaluation of clinical data we address the apparent shortcoming of greyscale transrectal ultrasonography in the assessment of prostate cancer. New developments and future possibilities are also discussed.Evaluation of the value of greyscale transrectal ultrasonography in the diagnosis of prostate cancer indicates a limited role, because of the non-uniform appearance of prostate cancer on the ultrasound images. Ameliorating of transrectal ultrasound, like the use of contrast ultrasonography, could improve the detection of prostate cancer.Although the use of greyscale transrectal ultrasonography lacks sensitivity and speci®city for the diagnosis of prostate cancer, its use in volume measurement of the prostate and biopsy guidance is unquestionable. The ®rst results of the application of contrast ultrasonography are promising, both in detection of prostate cancer as in treatment follow up. Other developments like improvement of transducer and computer technology could make the use of ultrasound more versatile. However, future research will indicate whether all these improvements will lead to clinical applications.

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Color doppler-guided prostate biopsies in 591 patients with an elevated serum psa level: Impact on gleason score for nonpalpable lesions

Cited by 82 publications

References 21 publications

Real-time elastography in the diagnosis of prostate tumor

Real-time elastography in the diagnosis of prostate tumor

Predictive Factors of Post-Void Residual Urine in Patients with Lower Urinary Tract Symptoms

Transrectal ultrasound imaging of the prostate: review and perspectives of recent developments

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