Lesson 17 (Part 3)

Question 1

What percentage of cancers can biopsy detect?

Answer 1

80%

Question 2

What is PSA a marker for?

Answer 2

Prostate cancer aggressiveness

Question 3

When is a biopsy recommended? (3)

Answer 3

1. PSA levels are > 2.5ng/mL
2. Suspicious nodule found during a DRE
3. Nodule on an ultrasound with a normal PSA

Question 4

What anatomy is assessed for a male pelvis ultrasound? (3)

Answer 4

1. Prostate
2. Seminal vesicles
3. Bladder

Question 5

What is transabdominal male pelvic ultrasound good for? (2)

Answer 5

1. Gross prostate

2. Bladder evaluation

Question 6

What is transabdominal male pelvic ultrasound limited to? (3)

Answer 6

1. Prostate size
2. Prostate shape
3. Prostate weight

Question 7

Why is the transabdominal male pelvic ultrasound limited? (2)

Answer 7

1. Detail is inadequate
2. Almost all cancer is in the posterior aspect of the prostate
   - not seen transabdominally

Question 8

How can you better evaluate the prostate?

Answer 8

With TRUS

Question 9

TRUS

Answer 9

TransRectal UltraSound

Question 10

What can the prostate gland be imaged through?

Answer 10

A full bladder

Question 11

How do you calculate the prostate volume?

Answer 11

L x W x AP x 0.523

Question 12

What volumes do you get of the bladder during ultrasound? (2)

Answer 12

1. Prevoiding

2. Postvoiding

Question 13

What is the weight of a normal prostate?

Answer 13

20g

Question 14

What is the normal width of the prostate?

Answer 14

4cm

Question 15

What is the normal AP width of the prostate?

Answer 15

3cm

Question 16

What is the normal length of the prostate?

Answer 16

3.8cm

Question 17

What is the normal volume of the prostate?

Answer 17

23.8cc

Question 18

With doing a transabdominal ultrasound of the male pelvis, what can be seen in transverse?

Answer 18

The right and left seminal vesicles

- symmetric

Question 19

What do seminal vesicles look like in sagittal?

Answer 19

Ovoid structures

Question 20

What is the echotexture of the prostate?

Answer 20

Heterogenous

Question 21

How should the prostate appear in ultrasound?

Answer 21

Symmetrical

- in shape and size

Question 22

What does high attenuation cause?

Answer 22

Shadowing

Question 23

What are the major reasons to get a TRUS? (3)

Answer 23

1. Prostate cancer evaluation
2. Biopsy
3. Guidance of therapeutic procedures

Question 24

What are the less common reasons to get a TRUS? (3)

Answer 24

1. Infertility
2. Prostatitis
3. Biopsy any accessible lesion in the pelvis
   - men and women

Question 25

What is the sonographers role during a TRUS? (5)

Answer 25

1. Explain the procedure to the patient 2. What is going to happen and when 3. If they have any questions 4. Obtain verbal consent - and written 5. Explain potential complications

Question 26

What is the patients positioning for TRUS

Answer 26

Left lateral decubitus with leg together and bent up

Question 27

What is performed before inserting the probe for a TRUS? By who?

Answer 27

1. DRE | 2. By a radiologist

Question 28

What is the frequency of the probe for a TRUS?

Answer 28

7-11MHz | - increased frequency results in better resolution

Question 29

How are the seminal vesicles oriented in a transverse plane during a TRUS scan?

Answer 29

Seminal vesicles are at the base of the prostate

Question 30

What kind of scanning do you use with TRUS scanning? (2)

Answer 30

1. Gray scale 2. Doppler - flow imaging in transverse for vascular symmetry