Local Staging of Prostate Cancer Using Three Dimensional (3D) Transrectal Ultrasound Assisted with Power Doppler Capability
Pages 30-36
Ashraf Talaat Youssef
DOI: https://doi.org/10.6000/1927-7229.2017.06.01.5
Published: 26 January 2017

Abstract: Introduction: The ability to differentiate between carcinoma confined to the prostate and the extra-capsular extension (ECE) of the tumor is the key point for management. ECE of prostate cancer can lead to failure of radical prostatectomy and every attempt should be made to localize the tumor and assess its extensions preoperatively. The study aimed to evaluate the value of three dimensional (3D) Transrectal ultrasound (TRUS) assisted with power Doppler in local staging of prostate cancer.

Methodology: -3D TRUS assisted with the power Doppler capability was performed for 120 patients were complaining of burning urination, difficult urination or blood in urine, among them 95 patients were subjected to 3D TRUS guided biopsies.

Results: 33 patients showed prostatic carcinomas, 2 patients showed prostatic sarcoma. In patients with proven prostate cancer 3D TRUS showed an estimated sensitivity 85.7% and specificity 90% with a positive predictive value 83.3%, negative predictive value 91.5% and total accuracy 90.9%. 77% of our cancer patients (27/35) showed hypervascularity by power Doppler ultrasonography while 8 patients (23%) showed no abnormal high vascularity. Power Doppler increased the sensitivity of 3D TRUS in the detection of prostate cancer from 85.7% to 88.5% 3D TRUS clearly identified the extra-prostatic spread in 15 out of 18 patients of an estimated sensitivity (83%).

Conclusion: 3D TRUS aided with power Doppler is a valuable tool in local staging of prostate cancer .The expected benefits in local staging of prostate cancer from the combination of 3D TRUS, power Doppler and 3D TRUS guided biopsy as one sitting exam, will be highly promising.

Viability of Whole Tissue Microbiopsy (WTM) for the Study and Management of Oral Leukoplakia
Pages 132-138
Antonio Carrera Torres, Ángel Martínez-Sahuquillo Márquez, Isabel Gallardo Castillo, María José Cobos Fuentes and José Ramón Armas Padrón
DOI: http://dx.doi.org/10.6000/1927-7229.2016.05.04.1
Published: 21 November 2016

Abstract: Introduction: Leukoplakia is the most frequent potentially malignant disorder. Management and diagnosis requires clinical and histopathogical monitorization. Conventional biopsy generates patient morbidity and is considered a complex procedure for general dentists, which can delay initial diagnosis. To solve these problems, we have proposed a novel procedure denominated Whole Tissue Microbiopsy (WTM). The aim of this study is to evaluate the samples obtained with the WTM procedure and to test their viability; to check if they are applicable in all anatomic locations and compare the results with those obtained with conventional biopsy.

Methods: We studied 41 clinically compatible lesions with oral leukoplakia. A tissue sample was taken using the WTM technique, after which, a conventional biopsy was performed on the same location. Both samples were studied and compared in terms of viability and concordance.

Results: 100% of the samples obtained using the WTM procedure were viable. 95% of the samples were useful to detect dysplasia, and in 85% of cases the basal membrane was retained. Coincidence with conventional biopsy as to detect cancer-dysplasia was 78% and showed a 53.8% sensitivity regarding the detection of dysplasia-Cancer.

Discussion and Conclusion: The samples obtained by the WTM are viable for study. Conservation of all epithelial layers in the sample and the basement membrane in particular is not influenced by the anatomical area or by the clinical appearance of the lesion. The results that did not coincide with the conventional biopsy were due to the difference in size and not the quality of it.