RESUMO
OBJECTIVE: To assess the feasibility of gallium 68 (Ga)-prostate specific membrane antigen (PSMA) PET/computed tomography (CT) to identify patients who truly harbor clinically significant prostate cancer (PCa) in a cohort of patients with clinical and biochemical/radiological suspicion of PCa. PATIENTS AND METHODS: A total of 118 patients with suspected PCa who underwent Ga-PSMA PET/CT between May 2015 and June 2016 were prospectively included. Final decision on performing biopsy was left to the referring urologist after considering the clinical data, scan findings and discussion with the patient. RESULTS: Overall, 51 patients were scan negative, among whom six underwent biopsy but was negative for malignancy. In 45 patients, an immediate biopsy could be avoided and put on follow-up. None of these patients were documented to have PCa in the short average follow-up of 6 months. Among 67 patients who were scan positive, 56 patients underwent transrectal ultrasonography-guided biopsy, and malignancy could be documented in 46 of them. In addition, comprehensive initial staging information could be obtained in them, with organ-confined disease demonstrated in 33 patients and metastatic disease in 13 patients. CONCLUSION: Ga-PSMA PET/CT can act as a gate keeper in selecting patients with suspected PCa who should undergo an immediate transrectal ultrasonography-guided biopsy and who could be kept on active surveillance.
Assuntos
Ácido Edético/análogos & derivados , Oligopeptídeos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Isótopos de Gálio , Radioisótopos de Gálio , Humanos , Processamento de Imagem Assistida por Computador , Biópsia Guiada por Imagem , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/patologia , UltrassonografiaAssuntos
Ácido Edético/análogos & derivados , Fluordesoxiglucose F18 , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Oligopeptídeos , Osteíte Deformante/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias Retais/diagnóstico por imagem , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Diagnóstico Diferencial , Isótopos de Gálio , Radioisótopos de Gálio , Humanos , Masculino , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos , Doenças Raras/diagnóstico por imagemRESUMO
OBJECTIVE: To report a case of pseudoaneurysm causing massive hematuria with hemodynamic instability occurring after oocyte retrieval. DESIGN: Case report. SETTING: Tertiary care infertility clinic. PATIENT(S): A 34-year-old woman with endometriosis undergoing oocyte aspiration for IVF. INTERVENTION(S): Blood transfusion, cystoscopy, and resection and cauterization of pseudoaneurysm. MAIN OUTCOME MEASURE(S): Control of hematuria and hemodynamic stability. RESULT(S): Massive hematuria occurred after oocyte retrieval. Blood transfusion was given. Cystoscopy was done, and a bleeding pseudoaneurysm was seen. It was resected and cauterized. CONCLUSION(S): Pseudoaneurysm after oocyte retrieval has not been reported before. It resulted in massive hematuria causing hemodynamic instability. Immediate resuscitation and cystoscopy should be performed on all patients who present with persistent hematuria after oocyte retrieval. Injury to surrounding structures should always be kept in mind during oocyte retrieval.
