Skip to main content
Fig. 1 | Insights into Imaging

Fig. 1

From: New transperineal ultrasound-guided biopsy for men in whom PSA is increasing after Miles’ operation

Fig. 1

A 61-year-old man (case 9) with a high PSA value. a Diffusion-weighted axial image (b value = 1400 s/mm) shows a 2.0 cm hyperintense mass (white arrows) at the anterior midline base. The patient underwent Miles’ operation due to rectal cancer in 2011. Recently, his PSA was as high as 10.10 ng/mL. b Apparent diffusion coefficient (ADC) map axial image shows the tumor (white arrows) has low ADC values. The tumor was consistent with PI-RADS 5. c T2-weighted sagittal image shows that the tumor (white arrows) is located from base to midgland. The white asterisk indicates the absent rectum and anus. d Longitudinal TPUS image shows a hypoechoic tumor (white arrows). The black arrows indicate the prostate urethra in the path of the biopsy needle. The black asterisk indicates subcutaneous fat compressed by the transducer. e Longitudinal TPUS image shows a guideline (white arrowheads) for creating a needle path. It is placed in the center of the tumor (white arrows). However, it does not cross the prostate urethra to avoid injury. The black asterisk indicates subcutaneous fat compressed by the transducer. f The photograph shows a biopsy needle (black arrowhead) being introduced into the guider (white arrowhead) on the transducer (black asterisk). g Longitudinal TPUS image shows the hyperechoic path (white arrowheads) of the biopsy needle targeting the posterior aspect of the tumor (white arrows). However, it did not cross the prostate urethra. Only one core was obtained to avoid urethra injury. h Hematoxylin and eosin-stained slide shows the length (black arrows) of the cancer tissue occupying 80% of the entire core. GS 7 (3 + 4) was confirmed by a genitourinary experienced pathologist

Back to article page