ABSTRACT
Prostate cancer is the third leading cause of death and is the most common cause of cancer in elderly men. Regarding to the low accuracy of screening methods such as prostate-specific antigen [PSA], Digital Rectal Examination [DRE] and trans rectal ultrasound [TRUS] in detection and localization of tumor, Magnetic Resonance Imaging [MRI] and Diffusion Weighted Imaging [DWI] attracted many attentions in the past years. DWI reveals micro-molecular diffusion, which is the Brownian motion of the spins in biologic tissues. This technique can delineate pathologic lesions with high tissue contrast against generally suppressed background signal. In this paper, the value of DWI in detection of prostate cancer is studied. In this cross-sectional study, the studied population are suspicious patients to prostate cancer based on high Prostatic Specific Antigen level or abnormal Digital Rectal Examination who refered for prostate biopsy to radiology department of Hazrat-e- Rasoul Hospital during the year 2011. The results of DWI are compared to biopsy results for all patients. Eighty five patients are selected. The DWI sensitivity in detecting of prostate cancer is 100%, specificity 97.1% and positive and negative predictive values are 89.5% and 100%, respectively. The results showed that if DWI reports the prostate cancer as negative, the result was highly reliable and if it reports as positive, although the report was not 100% reliable, but it still had high reliability, more than 90%. DWI had high accuracy in detecting prostate cancer for patients with cancer. Also the accuracy of this method for patients without prostate cancer was acceptable compared to the other common methods.
Subject(s)
Humans , Male , Prostatic Neoplasms/diagnosis , Cross-Sectional StudiesABSTRACT
The main goal of this report was to share with clinicians an atypical presentation of pulmonary thromboembolism [PTE] in a young male's post-appendectomy, whom he had no significant predisposing factors for such disease. The case also introduced for re-examining the challenges of PTE clinical manifestations which may mimic other differential diagnosis. PTE is an abrupt blockage of the pulmonary artery by a thrombus. Such thrombus is generated by a blood clot which has been formed, separated and migrated from the leg and/or pelvic veins toward the lung. The lung tissue's circulation is impaired which later episode results hypoxia and infarction. These events initiate a set of PTE clinical manifestations
Subject(s)
Humans , Male , Pulmonary Embolism , Postoperative Complications , Venous Thrombosis , ImmobilizationABSTRACT
Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins. In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year [1390]. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites. The mean age of the patients was 35.8 +/- 8.9 years. 36 [80%] patients had venous leakage in crural veins, 27 [60%] in cavernosal veins, 27 [60%] in circumflex veins, 24 [52.3%] in urethral veins, 21 [46.7%] in deep dorsal vein, 3 [6.7%] in para-arterial veins and 3 [6.7%] in corpus spongiosum. The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.
ABSTRACT
Prostate cancer is the most common cancer and the second cause of cancer mortality in men. Although histopathological examination is the gold-standard for its diagnosis, tendency toward less invasive methods is growing. The purpose of this study was to evaluate the relationship between choline plus creatine- to-citrate ratio in magnetic resonance spectroscopy [MRS] with the invasion of prostate cancer in a series of patients with prostate cancer. Totally, 200 patients with pathologically proven prostate cancer were enrolled in this cross-sectional study by a non-probability sampling method in Hazrat Rasul Akram Hospital in Tehran, Iran during 2009-2010. Pathological staging was the gold standard for the diagnosis of prostate cancer while the patients underwent MRS for choline plus creatine- to-citrate ratio determination. MRS and pathological results were compared and analyzed. The mean [ +/- SD] values of choline plus creatine- to-citrate ratio in patients with Gleason scores less than 3, 3 to 4 and greater than 4 were 245.8 +/- 146.8, 427.1 +/- 173.6 and 427.1 +/- 173.6, respectively [P<0.001]. The mean [ +/- SD] values of choline plus creatine- tocitrate ratio in patients with PSA levels less than 4, 4 to 10 and greater than 10 were 180.7 +/- 58.3, 247 +/- 93.5 and 385.1 +/- 106.6, respectively [P<0.001]. Choline plus creatine- to-citrate ratio determined by magnetic resonance spectroscopy has a significant relationship with the degree of invasion of prostate cancer and can be used for the staging of the disease.
ABSTRACT
The objective of this study was to evaluate the value of serum prostate-specific antigen [PSA] and prostate-specific antigen density [PSAD] in the diagnosis of prostate cancer. A total of 330 consecutive patients suspected of having prostate cancer due to either abnormal digital rectal examination or elevated serum PSA levels underwent transrectal ultrasonography-guided sextant biopsy of the prostate. The PSA and PSAD values were assessed based on the biopsy results. One hundred and twenty-one patients [36.7%] had prostate cancer. In this group, the mean PSA was 31.60 +/- 30.85 ng/mL [range, 1.9 ng/mL to 166.0 ng/mL] and the mean PSAD was 0.83 +/- 1.01 [range, 0.04 ng/mL/ cm[3] to 6.38 ng/mL/cm[3]]. In those without prostate cancer the mean PSA and PSAD levels were 13.80 +/- 18.72 ng/mL [range, 0.4 ng/mL to 130.0 ng/mL; P < .001] and 0.24 +/- 0.32 [range of 0.01 ng/mL/cm[3] to 2.29 ng/mL/ cm[3] P < .001]. The receiver operating characteristic curve analysis revealed that the discriminating power of serum PSA for detecting prostate cancer, as estimated by the area under the curve, was 0.74 while that for PSAD was 0.81 [P < .001]. For the PSA range of 3.5 ng/mL to 41 ng/mL [gray zone] the areas under the curve was 0.68 for PSA, while it was 0.78 for PSAD [P < .001]. The use of PSAD instead of PSA in the diagnosis of prostatic cancer improves the diagnostic accuracy