Biomedical subjects

P Jajodia

Publications and source records attributed to P Jajodia.

8 recordsLinked to original sources

PubMed1993

The value of prostate specific antigen and transrectal ultrasound guided biopsy in detecting prostatic fossa recurrences following radical prostatectomy.

The combination of prostate specific antigen (PSA) and transrectal ultrasonography was used to detect recurrent cancer in the prostatic fossa after radical prostatectomy. A total of 43 patients with persistently elevated PSA levels and negative bone scintigraphy following radical prostatectomy underwent digital rectal examination and transrectal ultrasonography. Ultrasound findings were considered suspicious if the scan showed any unusual hypoechoic tissue adjacent to the bladder neck, retro-trigone or peri-anastomotic site. Of 22 patients (51%) with biopsy proved cancer 21 (95%) had positive transrectal ultrasonography, while digital rectal examination was able to detect cancer in only 10 (45%). Among transrectal ultrasonography detected recurrences 15 (68%) were detected at the initial biopsy and 7 (32%) at repeat biopsies. Our study shows that the combination of PSA and transrectal ultrasonography provides a more effective method than digital rectal examination and PSA to detect biopsy proved cancer following radical prostatectomy.

Adenocarcinoma↗

PubMed1991

31P spectroscopy of the human prostate gland in vivo using a transrectal probe.

Using a transrectal probe, good quality 31P magnetic resonance spectroscopy of the human prostate was performed safely, consistently, and in a reasonable amount of time (average of 60 min). Initial results indicate that transrectal 31P MRS has the ability to characterize the phosphorylated metabolites of normal, hyperplastic, and malignant prostates. This study demonstrated that malignant prostates are characterized by significantly decreased levels of phosphocreatine (PCr) and increased levels of phosphomonoesters (PME) as compared to healthy prostates.

Adult↗

PubMed1991

Characterization of prostate cancer, benign prostatic hyperplasia and normal prostates using transrectal 31phosphorus magnetic resonance spectroscopy: a preliminary report.

We assessed the ability of 31phosphorus (31P) transrectal magnetic resonance spectroscopy to characterize normal human prostates as well as prostates with benign and malignant neoplasms. With a transrectal probe that we devised for surface coil spectroscopy we studied 15 individuals with normal (5), benign hyperplastic (4) and malignant (6) prostates. Digital rectal examination, transrectal ultrasonography and magnetic resonance imaging were used to aid in accurate positioning of the transrectal probe against the region of interest within the prostate. The major findings of the in vivo studies were that normal prostates had phosphocreatine-to-adenosine triphosphate (ATP) ratios of 1.2 +/- 0.2, phosphomonoester-to-beta-ATP ratios of 1.1 +/- 0.1 and phosphomonoester-to-phosphocreatine ratios of 0.9 +/- 0.1. Malignant prostates had phosphocreatine-to-beta-ATP ratios that were lower (0.7 +/- 0.1) than those of normal prostates (p less than 0.02) or prostates with benign hyperplasia (1.1 +/- 0.2, p less than 0.01). Malignant prostates had phosphomonoester-to-beta-ATP ratios (1.8 +/- 0.2) that were higher than that of normal prostates (p less than 0.02). Using the phosphomonoester-to-phosphocreatine ratio, it was possible to differentiate metabolically malignant (2.7 +/- 0.3) from normal prostates (p less than 0.001), with no overlap of individual ratios. The mean phosphomonoester-to-phosphocreatine ratio (1.5 +/- 0.5) of prostates with benign hyperplasia was midway between the normal and malignant ratios, and there was overlap between individual phosphomonoester-to-phosphocreatine ratios of benign prostatic hyperplasia glands with that of normal and malignant glands. To verify the in vivo results, we performed high resolution magnetic resonance spectroscopy on perchloric acid extracts of benign prostatic hyperplasia tissue obtained at operation and on a human prostatic cancer cell line DU145. The extract results confirmed the differences in metabolite ratios observed in vivo. We conclude that transrectal 31P magnetic resonance spectroscopy can characterize metabolic differences between the normal and malignant prostate.

Adult↗

PubMed1991

Core biopsy instrument in the diagnosis of prostate cancer: superior accuracy to fine needle aspiration.

The recent availability of an automated core biopsy gun has made the performance of core biopsies of the prostate easier and better tolerated. A prospective study was conducted to compare the efficacy of fine needle aspiration to core biopsy with the gun. Among 94 patients subjected to both biopsy techniques at the same visit 30 (32%) had a positive diagnosis of prostate cancer. Core biopsy was positive in these 30 patients (100%), while fine needle aspiration was positive in 21 (70%). This study suggests that core biopsy with the gun is superior to fine needle aspiration in the diagnosis of prostate cancer.

Biopsy, Needle↗

PubMed1990

Prostatic oncology.

Prostate cancer is the most common cancer in men in the United States. Management of prostatic cancer has evolved over the last two decades based on a clearer understanding of the natural history and on improvements in the techniques of radiation therapy, surgery, and hormonal manipulation. Additionally, better methods of prevention and treatment of complications have helped to provide curative therapies for more patients of all ages. Discussion on these topics is followed by a section on special problems in management of elderly patients with prostate cancer.

Aged↗

PubMed1989

Transrectal probe for 1H MRI and 31P MR spectroscopy of the prostate gland.

A transrectal probe for 1H imaging and 31P MR spectroscopy of the prostate gland is described. The probe is covered with plastic and consists of an insectional portion containing an rf coil and a handle containing a tuning and matching circuit. Using this transrectal probe, 1H MR images and the first 31P MR spectra of the in situ canine prostate were obtained. Serial alterations in prostate size and changes in the ratio of phosphomonoesters to ATP ratio following orchiectomy were observed. Transrectal images of the prostate appear to be superior to conventional whole body coil images in the canine. For the first time a device to obtain high signal-to-noise 1H images and 31P spectra of the in situ prostate has been constructed. This will allow the assessment of transrectal imaging and spectroscopy as tools for medical studies of prostate pathophysiology.

Administration, Rectal↗

PubMed1989

A comparison of fine needle aspiration and core biopsy in diagnosis and preoperative grading of prostate cancer.

Fine needle aspiration biopsy has been documented to be safe and accurate for the diagnosis of prostate cancer. A study was done based on 3 objectives to determine 1) whether performing core biopsies and fine needle aspiration in each patient with a prostate nodule increases the detection rate of prostate cancer, 2) the accuracy of preoperative grading by fine needle aspiration in predicting the final pathological grade in radical prostatectomy specimens and 3) the usefulness of fine needle aspiration in screening for unsuspected stage A prostate cancer. Of 203 consecutive patients undergoing prostate biopsies core and fine needle aspiration biopsies were performed in 121. An additional 58 patients underwent prostate biopsies just before transurethral resection of the prostate and 24 underwent radical prostatectomy. The diagnostic accuracy of fine needle aspiration was superior to that of core biopsy (82 versus 74 per cent). Performance of both biopsies yielded a higher percentage of positive diagnoses than either biopsy alone (32.2 per cent versus 24 and 28 per cent). Except in poorly differentiated cancers, fine needle aspiration is a poor predictor of final pathological grade. Fine needle aspiration is not useful in detecting stage A1 prostate cancer. Although fine needle aspiration has several distinct advantages over core biopsies, there is a definite learning curve before its use can be fully exploited. It is important to have an experienced pathologist and to perform both biopsies at each center until sufficient experience is accumulated.

Biopsy↗

PubMedDate not supplied

Phosphorus metabolite characterization of human prostatic adenocarcinoma in a nude mouse model by 31P magnetic resonance spectroscopy and high pressure liquid chromatography.

A series of experiments were conducted to identify and quantify the phosphorus metabolites of DU 145 xenografts (a human prostatic adenocarcinoma cell line grown in nude mice) using 31P MRS and HPLC. The 31P spectral characteristics of DU 145 xenografts were compared to perfused DU 145 cells and to in situ human prostatic adenocarcinomas. These studies demonstrated that both DU 145 xenografts and perfused DU 145 cells exhibited reduced levels of phosphocreatine relative to spectra of in situ human prostatic adenocarcinomas. Elevated levels of phosphomonesters (PMEs) were observed in 31P spectra of both DU 145 xenografts and in situ human prostatic adenocarcinomas. The major components of the PME resonance of DU 145 xenografts were identified as phosphocholine and phosphoethanolamine. High levels of diphosphodiesters (DPDEs) were consistently observed for both DU 145 xenografts and perfused DU 145 cells, but were absent in 31P spectra in in situ primary human adenocarcinomas. In agreement with spectroscopic results, high pressure liquid chromatographic analyses of human tissue removed at surgery contained insignificant amounts of DPDEs while DU 145 xenografts had high levels of DPDEs consisting mainly of uridine-5'-diphospho-N-acetylgalactosamine (22.4 nmol/mg protein) and uridine-5'-diphospho-N-acetylglucosamine (7.4 nmol/mg protein).

Adenocarcinoma↗