Diplomate of National Board, New Delhi

SYNOPSIS

Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore

“TRANSRECTAL ULTRASONOGRAPHY FOR EVALUATION OF BENIGN AND MALIGNANT PROSTATIC LESIONS WITH HISTOPATHOLOGICAL CORRELATION”

Name of the candidate : DR. YASSIR M. ABDULLA

Guide : DR.NAVEENCHANDRA M. SHETTY. MD, DMRD.

Course and Subject : MD (RADIO DIAGNOSIS).

Department of Radio Diagnosis,

Father Muller Medical College Hospital

Kankanady, Mangalore – 575002.

1 August – 2011

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. NAME OF THE DR. YASSIR M. ABDULLA CANDIDATE AND POST GRADUATE RESIDENT, ADDRESS DEPT OF RADIO DIAGNOSIS, FATHER MULLER MEDICAL COLLEGE, KANKANADY, MANGALORE – 575002.

2. NAME OF THE FATHER MULLER MEDICAL COLLEGE, INSTITUTION KANKANADY, MANGALORE – 575002.

3. COURSE OF STUDY MD (RADIO DIAGNOSIS). AND SUBJECT

DATE OF ADMISSION

4. TO THE COURSE 01-04-2011

2 TITLE OF THE TOPIC : 5. “ TRANSRECTAL ULTRASONOGRAPHY FOR EVALUATION OF BENIGN AND MALIGNANT PROSTATIC LESIONS WITH HISTOPATHOLOGICAL CORRELATION”

BRIEF RESUME OF THE INTENDED WORK:

6. 6.1 NEED FOR THE STUDY:

Transrectal ultrasonography(TRUS) has traditionally been considered as the

pivotal imaging test for the prostate, providing clinically important information

regarding benign and malignant conditions including Benign Prostatic Hyperplasia

(BPH), prostatitis, obstructive infertility, and prostate cancer.

The most common indication for TRUS examination of the prostate is the

evaluation for suspected prostate cancer. Prostate cancer is the most common tumor

in middle aged and elderly men throughout world and third most frequent cause of

death from cancer.1 Apparently, early detection of prostate cancer contributes to a

reduction in mortality with treatment of early localized disease being the only

chance of cure .

Before the widespread availability of diagnostic tools enabling early detection

of the disease, such as Digital Rectal Examination(DRE), Total Prostate specific

Antigen(tPSA) measurement and TRUS, prostate cancer was frequently diagnosed at

an advanced stage.

However there is a lack of specificity for tPSA value, because tPSA more

than 4ng/ml can imply the presence of prostate cancer , patients with BPH and

inflammatory prostate disorders can also present with increased serum tPSA levels.2

3 Hence, there is a need for an alternate, cost effective and efficient modality for screening, detection, and differentiation of prostate diseases.

6.2 REVIEW OF LITERATURE:

Sperandeo G. et al1., evaluated compressibility of prostate lesions on TRUS.

They concluded that ultrasound guided compression of suspicious prostate lesions detected on TRUS is a simple, rapid and reliable maneuver that will increase the diagnostic potential of TRUS.

R. Malik et al.3, did a correlative TRUS study on patients with clinical suspicion of prostatic disease. In this study, the sensitivity and specificity of TRUS for diagnosis of carcinoma prostate was found to be 86.96% and 71.43% respectively.

Boczko J. et al.4, studied the accuracy of Transrectal ultrasonography in prostate evaluation and found that TRUS is an essential tool to detect prostate pathology and perform the prostate biopsies.

Shigeno K. et al5., evaluated the usefulness of color Doppler ultrasonography

(CDUS) in prostate cancer by comparing CDUS with grey scale TRUS and magnetic resonance imaging (MRI). They found that CDUS is useful when used with grey scale TRUS and should be included in routine examination for prostate cancer.

OBJECTIVES OF THE STUDY:

1) To evaluate the TRUS findings in benign and malignant prostatic lesions with

respect to its site, echopattern, capsular status, local invasion, compressibility and

4 their histopathological correlation.

2) To study the accuracy of TRUS in differentiating neoplastic from non neoplastic

lesions.

5 7. MATERIAL AND METHODS

7.1 SOURCE OF DATA :

A minimum of 30 patients with suspected prostate disease, referred to

Department of Radiodiagnosis at Father Muller Medical College Hospital,

Mangalore will be included in the study.

7.2 METHOD OF COLLECTION OF DATA:

This is a correlative type of study. Data will be collected from a minimum

of 30 cases of suspected prostate lesions referred for TRUS. The period of study

will be for 2 years from June 2011- May 2013.

Prior to the TRUS examination, rectal cleansing either by enema or laxative

will be done. Patient will be advised to be in left lateral decubitus position with

knees flexed . After performing DRE to ensure no rectal abnormalities TRUS will be

done using Philips HD 11 scanner equipped with high frequency (4-8 MHz)

endocavity probe , which will be wrapped in a sheath. To ensure acoustic contact

the sheath contained ultrasound gel. The sheath coated with gel for adequate

lubrication, will be inserted into the rectum. The prostate gland will be evaluated

first with grey scale imaging followed by color Doppler to assess the presence of

any focal lesions and their ecopattern, compressibility, capsular integrity, extension

of the disease process outside the limits of the gland margin. TRUS findings will

be correlated with the biopsy or histopathological examination of the prostate

specimen.

STATISTICAL ANALYSIS: 6 9. SIGNATURE OF THE CANDIDATE

STUDY CAN BE CONDUCTED 10. REMARKS OF THE GUIDE

11. 11.1 NAME AND DR. NAVEEN CHANDRA M . SHETTY DESIGNATION OF GUIDE MD, DMRD. (in block letters) PROFESSOR & H.O.D DEPARTMENT OF RADIODIAGNOSIS FATHER MULLER MEDICAL COLLEGE, KANKANANDY, MANGALORE.

11.2 SIGNATURE

11.3 CO GUIDE (if any) -

11.4 SIGNATURE -

11.5 HEAD OF THE DR. NAVEEN CHANDRA M. SHETTY DEPARTMENT MD, DMRD. PROFESSOR & H.O.D DEPARTMENT OF RADIODIAGNOSIS FATHER MULLER MEDICAL COLLEGE, KANKANANDY, MANGALORE.

11.6 SIGNATURE

12. 12.1 REMARKS OF THE CHAIRMAN AND PRINCIPAL

12.2 SIGNATURE