• The Korean Journal of Urological Oncology
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• v.16 no.3
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• pp.110-118
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• 2018

Purpose: The aim of this study is to confirm the detection rate of transperineal biopsy after multiparametric magnetic resonance imaging (mpMRI) and compared it to that of transrectal biopsy. We also examined the role of mpMRI and the rate of complications for each method. Materials and Methods: In a retrospective study, we analyzed 147 patients who underwent mpMRI before prostate biopsy because of elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings at Korea University Hospital, Seoul, Korea from March 2017 to April 2018. Regions on the mpMRI that were suggestive of prostate cancer were categorized according to the Prostate Imaging-Reporting and Data System (PI-RADS v2). For transperineal biopsy, a 20-core saturation biopsy was performed by MRI-TRUS cognitive or fusion techniques and a 12-core biopsy was performed in transrectal biopsy. Results: Sixty-three and 84 patients were enrolled in transperineal group and transrectal group, respectively. The overall detection rate of prostate cancer in transperineal group was 27% higher than that in transrectal group. Classification according to PI-RADS score revealed a significant increase in detection rate in all patients, as the PI-RADS score increased. Frequency of complications using the Clavien-Dindo classifications revealed no significant differences in the total complications rate, but two patients in transrectal group received intensive care unit care due to urosepsis. Conclusions: Our results confirmed that transperineal biopsy is superior to transrectal biopsy for the detection of prostate cancer. From the complication point of view, this study confirmed that there were fewer severe complications in transperineal biopsy.

• Advances in pediatric surgery
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• v.13 no.1
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• pp.76-80
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• 2007

The authors applied anterior sagittal transrectal apporach (ASTRA) for the repair of urethrovaginal fistula which developed after total repair of persistent cloaca. The patient had been diagnosed to have persistent cloaca, double uterus and double vagina, and received PSARP, excision of right-side uterus and vagina, and left vaginal switch operation at 22 months old. After operation, the patient admitted several times due to frequent urinary tract infection and ectopic stone formation in bladder and neovagina. Urethro-neovaginal fistula was confirmed by cystoscopy and corrected with ASTRA. Postoperative voiding cystourethrogram showed no fistula tract. ASTRA showed improved surgical field, minimized ureterocystic damage, and preserved perirectal nerve due to limited incision of rectum.

• Journal of Embryo Transfer
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• v.22 no.4
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• pp.209-212
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• 2007

This study was performed to establish the early pregnancy diagnosis with evaluation of size of embryonic vesicles and change of crown-rump length (CRL) by transrectal ultrasonography in the Korean black goats. Early pregnancy diagnosis was performed in the 114 goats from 19 to 35 days after coitus by transrectal 5.0 MHz transducer. Embryonic vesicles and CRL in the 142 goats from 19 to 42 days was measured to establish the correlation between gestational age and these parameters. The early pregnancy diagnosis achieved 80% accuracy after days 25 and 100% accuracy after days 28 after breeding. Diameters of embryonic vesicle and CRL were significantly increased with the gestational age. In these facts, early pregnancy diagnosis is possible on Days 25 after breeding and measurement of embryonic vesicles and CRL were useful to predict the gestational age in Korean black goat.

• Korean Journal of Veterinary Research
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• v.37 no.3
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• pp.687-692
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• 1997

개의 전립선에서 경직장 초음파상에 나타나는 미만성 저에코영역의 성상과 경직장 초음파 검사법의 유용성을 알아보기 위해 히스토그람 분석방법과 color doppler 초음파를 이용하여 전립선 맛사지에 따른 전립선 실질의 에코변화를 비교하였다. 전립선 맛사지 후 히스토그람상의 휘도치는 전립선 요도부 기준 상부측 실질내에서 유의성(p<0.01) 있게 고에코로 변화되어 나타났으며, 전립선내에 분포하는 혈관은 저에코영역에서 보다 고에코영역에서 발견되었다. 이상의 결과로 보아 경직장 초음파 검사법은 전립선의 미세한 변화에 대해 보다 상세한 실질내의 정보를 제공할 수 있는 효과적인 검사 방법이며, 맛사지에 따른 휘도치의 변화는 전립선의 물리적 자극에 대한 전립선액의 분비에 따른 결과로 사료되고, 저에코영역은 혈관보다는 전립선액이 점유하고 있는 것으로 생각된다.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2017.05a
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• pp.269-270
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• 2017

Ultrasonography of benign prostatic hypertrophy(BPH) has been used a lot to determine the size of the prostate with a biopsy. In this study, we measured the size of the prostate in a proportion of the transition zone and the peripheral zone quantitatively, we propose a method that can be diagnosed with BPH automatically ultrasound image.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3087-3091
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• 2014

Purpose: To determine the utility of digital rectal examination (DRE), serum total prostate specific antigen (tPSA) estimation, and transrectal ultrasound (TRUS) for the detection of prostate cancer (PCa) in men with lower urinary tract symptoms (LUTS). Materials and Methods: All patients with abnormal DRE, TRUS, or serum tPSA >4ng/ml, in any combination, underwent TRUS-guided needle biopsy. Eight cores of prostatic tissue were obtained from different areas of the peripheral prostate and examined histopathologically for the nature of the pathology. Results: PCa was detected in 151 (50.3%) patients, remaining 149 (49.7%) showed benign changes with or without active prostatitis. PCa was detected in 13 (56.5%), 9 (19.1%), 26 (28.3%), and 103 (74.6%) of patients with tPSA <4 ng/ml, 4-10 ng/ml, 10-20 ng/ml and >20 ng/ml respectively. Only 13 patients with PCa had abnormal DRE and TRUS with serum PSA <4 ng/ml. The detection rate was highest in patients with tPSA >20 ng/ml. The association between tPSA level and cancer detection was statistically significant (p<0.01). Among 209 patients with abnormal DRE and raised serum PSA, PCa was detected in 128 (61.2%). Conclusions: The incidence of PCa increases with increasing serum level of tPSA. The overall screening and detection rate can be further improved by using DRE, TRUS and TRUS-guided prostate needle biopsies.

• The Journal of the Korea Contents Association
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• v.12 no.6
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• pp.338-345
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• 2012

Benign prostatic hyperplasia (BPH) is increasing in Korea owing to the westernized eating habits and changes in living environment. However, very few studies have been made to determine the standard value of the prostate volume as a diagnostic reference. Also, most of the previous studies have been focusing on the elder population over 40 years old. This study retrospectively analyzes the results of prostate volume measured by transrectal ultrasonography in the healthy Korean men in their 30's who visited our institution's center for health promotion for routine checkups. The mean age of the total of 157 men enrolled was $34.6{\pm}2.9$ years, and the mean prostate volume was $19.4{\pm}4.0ml$. Prostate volume of these men was correlates proportionally to their age, prostate specific antigen, body mass index, body surface area, and abdominal girth. Among these, the strongest correlation is between the prostate volume and the abdominal girth (r=0.317, p<0.001).

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.191-197
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• 2004

Background: This study was performed to reconsider the efficacy of transrectal ultrasonography (TRUS) in diagnosing prostate cancer by analyzing the results of a digital rectal examination (DRE), serum prostate-specific antigen (PSA) and a transrectal ultrasonography in patients with prostate specific antigen levels of 10 ng/ml or less. Materials and Methods: One-hundred and eighty one men with PSA levels of 10 ng/ml or less, who had a TRUS-guided tissue biopsy performed, were included in this study. The detection rate of prostate cancer was compared according to the TRUS result and the presence or absence of nodularity and the consistency of the prostate on DRE. Results: In a total 181 patients, there were 73 patients with PSA levels of 4 ng/ml or less and 4 of them had prostate cancer. Thre were 108 patients with PSA levels of 4-10 ng/ml and 18 of them were prostate cancer. TRUS was performed in 152 patients and 16 out of 58 patients diagnosed with prostate cancer, 3 out of 39 diagnosed with suspicious prostate cancer, and 2 out of 55 patients diagnosed as having no prostate cancer were found to have prostate cancer. In 40 patients, a nodule was palpated on DRE and 8 of them were found to have prostate cancer. Five out of 19 patients with a stony hard consistency, 3 of 12 with a firm to hard consisency, 12 of 129 with a firm consistency, 0 of 13 with a soft to firm consistency, and 2 of 8 with a soft consistency were prostate cancer. In the prostate cancer patients, there were 4 patients with PSA levels of 4 ng/ml or less and all these patients were diagnosed with prostate cancer or suspicious prostate cancer on TRUS but the nodule was not palpated in all patients. Two were soft and 2 were firm consistency on DRE. Conclusion: In patients with serum PSA levels of 10 ng/ml or less, TRUS is a more useful supporting method than DRE and a more active application of TRUS may lead to an early diagnosis and pertinent treatment of prostate cancer.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1110-1122
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• 2023

Purpose This study aimed to assess the variability of transrectal shear wave elastography (SWE) using a designed phantom. Materials and Methods In a phantom, the SWE values were examined by two radiologists using agarose and emulsion silicone of different sizes (1, 2, and 3 cm) and shapes (round, cubic) at three depths (1, 2, and 3 cm), two region of interest (ROI) and locations (central, peripheral) using two ultrasound machines (A, B from different vendors). Variability was evaluated using the coefficient of variation (CV). Results The CVs decreased with increasing phantom size. Significant changes in SWE values included; agarose phantom at 3 cm depth (p < 0.001; machine A), 1 cm depth (p = 0.01; machine B), emulsion silicone at 2 cm depth (p = 0.047, p = 0.020; both machines). The CVs increased with increasing depth. Significant changes in SWE values included; 1 cm agarose (p = 0.037, p = 0.021; both machines) and 2 cm agarose phantom (p = 0.047; machine A). Significant differences in SWE values were observed between the shapes for emulsion silicone phantom (p = 0.032; machines A) and between ROI locations on machine B (p ≤ 0.001). The SWE values differed significantly between the two machines (p < 0.05). The intra-/inter-operator agreements were excellent (intraclass correlation coefficient > 0.9). Conclusion The phantom size, depth, and different machines affected the variability of transrectal SWE.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1831-1835
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• 2014

Background: To investigate the relationship between extracellular matrix parameters and texture of prostatic lesions evaluated by transrectal real-time tissue elastography (TRTE). Methods: 120 patients suspicious for prostate cancer underwent TRTE. Targeted biopsies were carried out after 12-core systematic biopsy. Epithelia were stained with hematoxylin-eosin, and Victoria blue and Ponceau S were used to stain elastic-collagen fibers, and picric acid-sirius red for visualization of collagen type I (Col1) and III (Col3). Smooth muscles were visualized by immunohistochemistry. All image analyses were performed in a blind manner using Image Pro Plus 6.0, and the area ratios of epithelium, elastic fibers, collagen fibers and Col1/Col3 were determined. Results: 42 patients with typical elastograms were included in the final data analysis. Significant differences were detected between the benign and malignant groups in the area ratios of epithelium (P = 0.01), smooth muscles and Col1/Col3 (P = 0.04, P = 0.02, respectively). There were no significant differences in the area ratios of epithelium, smooth muscle and elastic fibers between the stiff and soft lesion groups. The area ratio of Col1 was ($0.05{\pm}0.03$) in the stiff group, and ($0.02{\pm}0.01$) in the soft group (P= 0.00). However, the area ratio of Col3 was ($0.03{\pm}0.02$) in the stiff group, and ($0.05{\pm}0.04$) in the soft group (P = 0.16). Col1/Col3 in the stiff group ($1.99{\pm}1.59$) was greater than in the soft group ($0.71{\pm}0.64$) (P = 0.01). Conclusions: Tissue hardness of prostatic tumors was mainly dependent on the Col1 content, Col1/Col3 being higher in malignant than in benign lesions, so the prostate tissue texture can be used as a target for distinguishing between the two with TRTE.