Ultrasound-guided genitourinary interventions: principles and techniques

Park, Byung Kwan

doi:10.14366/usg.17026

Cited by 27 publications

(41 citation statements)

References 66 publications

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“…Recently, new TRUS techniques and imaging features have been reported to detect significant cancer in patients with PI-RADS 4 or 5 [10]. Only a few articles have introduced the new biopsy techniques to set up the new protocols of TRUS and difference of lesion location between MRI and TRUS [10][11][12][13]. Therefore, there is no validation study to show how cancer detection has been improved with these new TRUS features and biopsy.…”

Section: Introductionmentioning

confidence: 99%

Validation of new TRUS biopsy techniques for PI-RADS 4 or 5

Park

2020

Precis Future Med

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Purpose: Recently, new magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) techniques and imaging features of Prostate Imaging and Report and Data System (PI-RADS) 4 or 5 have been reported. The aim of this study was to validate the outcomes of new TRUS-guided biopsy techniques for cancer detection in patients with PI-RADS 4 or 5. Methods: Between June 2018 and November 2018, 94 men underwent TRUS-guided biopsy after PI-RADS 4 (n = 59) or 5 (n = 35) was categorized as an index lesion on MRI. For PI-RADS 4 group, target biopsy was performed in 5 and combination biopsy (target and systematic biopsies) was in 54. For PI-RADS 5 group, target biopsy was performed in 19 and combination biopsy was in 16. Target to combination biopsy ratios and significant cancer detection rates (CDRs) were compared between the groups. Significant cancer was defined as a Gleason score ≥ 7 tumor. Standard reference was biopsy examination. Fisher's exact were used for statistical analysis. Results: Target to combination biopsy ratios was 5:54 in the PI-RADS 4 group and 19:16 in the PI-RADS 5 group (P < 0.0001). The significant CDR of the target biopsy were 42.4% (25/59) in the PI-RADS 4 group and 82.6% (29/35) in the PI-RADS 5 group (P = 0.0002). The significant CDR of combination biopsy was 44.1% (26/59) in the PI-RADS 4 group and 85.7% (30/35) in the PI-RADS 5 group (P < 0.0001). Conclusion: New TRUS biopsy techniques provides high significant CDR patients with PI-RADS 4 or 5. Therefore, TRUS should be performed prior to fusion or in-bore biopsy to determine if these categories are visible.

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Section: Introductionmentioning

confidence: 99%

Validation of new TRUS biopsy techniques for PI-RADS 4 or 5

Park

2020

Precis Future Med

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“…Second, using lower dynamic range also improved tissue contrast. Third, higher PI-RADS scores lead to not only a higher likelihood of significant cancer but also greater lesion conspicuity [16][17][18]. Fourth, lesions on TRUS are superiorly or inferiorly located than on MRI according to the tumor location.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive biopsy is used to obtain cores in which a tumor is expected to be located [18]. In contrast, targeted biopsy is used to obtain cores within a tumor that is detected on TRUS [16][17][18]. Therefore, a targeted biopsy is needed to accurately detect a PI-RADS 4 or 5 lesion and directly sample the tumor tissue.…”

Section: Discussionmentioning

confidence: 99%

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

Park

2020

JCM

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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.

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“…In addition, acoustic shadowing from the bowels in the pelvic cavity often makes the target lesion invisible. Thus, visualizing deep pelvic masses using transabdominal US is more difficult than visualizing superficially located lesions [10]. However, the distance between deep pelvic masses and the TRUS or TVUS probe is short because the proximal vagina or rectum is usually located in the central portion of the pelvic cavity [4,11].…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, the rate of diagnostic biopsies (i.e., those that enable a histologic diagnosis) is roughly 85%-95%. The proximity between the TRUS or TVUS probe and deeply located intrapelvic lesions improves the sonic window and shortens the biopsy distance, which may result in a good diagnostic yield of those approaches [4,10,11]. However, the data showing the usefulness of TRUS- and TVUS-guided biopsy are still insufficient, and it is also unclear whether TRUS- or TVUS-guided biopsy is useful in oncologic patients.…”

Section: Introductionmentioning

confidence: 99%