Palpable masses in the prostate: superior accuracy of US-guided biopsy compared with accuracy of digitally guided biopsy

Article Abstract:

Prostate cancer is the most commonly diagnosed cancer in men. It is usually suspected when a digital (finger) rectal examination detects a mass in the prostate region, and diagnosed when subsequent biopsy reveals that the mass is cancerous. Biopsies (removal of tissue for pathologic examination) have traditionally been conducted with digital guidance to locate the mass. These biopsies are only found to be cancerous 50 percent of the time, and have an estimated 10 percent false-negative rate (biopsy incorrectly indicates the mass is noncancerous). Ultrasound- or US-guided biopsy has recently become available. This technique uses ultrasound, or high-frequency sound waves, to image the endorectal area and determine where the biopsy tissue should be taken. This study examined the use of US-guided examination and biopsy on 112 patients with palpable prostate masses who first tested negative for cancer when digitally guided biopsy was performed. The US-guided biopsies were obtained either by the transrectal (through the rectum) or transperineal (through the perineum) route. Results showed that prostate cancer was diagnosed in 44 (39.3 percent) of the 112 patients when the US technique was used. Procedural complications were minimal and both transrectal and transperineal biopsies provided equivalent results. These findings indicate that the false-negative rate of digitally guided prostate biopsy is actually much higher than 10 percent. They also indicate that patients whose initial biopsies test negative should undergo US-guided biopsy for a definitive diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Prostate cancer, Biopsy

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Congenital cystic disease of the seminal vesicle

Article Abstract:

Congenital cystic disease of the seminal vesicles is a rare disease affecting males in which cysts form on the seminal vesicles, which are saclike structures that produce a viscous substance that becomes a component of the seminal fluid. These cysts are associated with renal agenesis (failure of the kidney to grow or develop) and other problems of the genitourinary system. This study characterized the findings in 21 patients with the disease using the imaging techniques of magnetic resonance (MR) imaging, ultrasonography (US), and computed tomography (CT). Of the 21 patients, 8 were found to not have congenital cystic disease. Cytoscopic and pathologic findings showed 12 of the 13 patients having kidney problems on the same side of the body as the affected seminal vesicle. In these 12 patients, the ureter from the kidney was inserted into the wrong place, usually into the ejaculatory ducts. The results of the imaging studies using CT showed cysts in the seminal vesicles, outlines of the ureter, but not the ectopic insertion points. The results of the US imaging studies also showed the cysts in the seminal vesicles. MR imaging results showed signs of the cysts in the seminal vesicles and the ectopic insertion points of the ureters. These imaging results indicate that the various problems associated with congenital cystic disease stem from problems in the mesonephric duct, which is the embryonic duct that gives rise to the male reproductive ducts. The imaging techniques are all useful in characterizing and identifying congenital cystic disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, CT imaging, CAT scans, Magnetic resonance imaging, Cysts, Genital diseases, Male, Male genital diseases, Genitourinary organs, Urogenital abnormalities

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