Jens Gammelgaard

Ultrasonically Guided Precise Needle Placement in the Prostate and the Seminal Vesicles

AbstractA method is described for precise ultrasonically guided puncture of the prostate and the seminal vesicles. A transrectal scanner with a special puncture attachment is used.

Transrectal ultrasonic volume determination of the prostate--a preoperative and postoperative study.

A technique for transrectal ultrasonic volume determination of the prostate, based on the principle of serial planimetry, is presented. The preoperative ultrasonic determinations in 75 cases have been compared to the estimation of size by digital palpation and to the amount of tissue removed at operation. Scannings 6 to 10 weeks postoperatively have shown variable amounts of residual prostatic tissue. The difference in the preoperative and postoperative ultrasonic volume has been compared to the amount of tissue resected at operation, and the accuracy of the method has been established. The transrectal approach gives a close and complete view of the prostate, and has proved to be a simple, easily applicable and reliable method for volume determination. Postoperative scannings show morphological changes in the resection cavity, which are difficult to explain from scanning alone.

Transurethral and Transrectal Ultrasonic Scanning in Urology

An ultrasonic scanner is described that can be used for transurethral as well as for transrectal scanning of the bladder, the prostate and the seminal vesicles. Transurethral scanning is performed as an integral part of a cystoscopy procedure, with a small rotating transducer through the cystoscope. Transrectal scanning is done with a larger transducer inside a water-filled balloon inserted into the rectum. We examined 200 patients with the scanner. The bladder was visualized best by the transurethral scanning, while the rectal approach was preferable for examination of the prostate and the seminal vesicles. The method has proved especially useful in staging bladder tumors and prostatic cancer, in estimating prostatic size and in detecting pathology, such as abscesses in the prostate and the seminal vesicles.

Endoluminal Ultrasonic Scanning in the Evaluation of Rectal Cancer: a Preliminary Report of 13 Cases

In 13 patients with a verified tumor of the rectum, endoluminal ultrasonic scanning was performed to evaluate the degree of tumor infiltration in the muscular wall and the perirectal tissue. In 11 cases the degree of tumor infiltration found by ultrasonic scanning was in complete accordance with the histopathologic finding. In 2 cases the examination was incomplete because the ultrasonic probe could not pass the tumor. We believe that endoluminal ultrasonic scanning with further development of the equipment will be a valuable additional diagnostic tool in the evaluation of gastrointestinal tract tumors. It will make it possible to decide whether local excision of the tumor is possible, based on the diagnostic procedure.

Transabdominal dynamic ultrasonography in detection of bladder tumors.

The accuracy of dynamic transabdominal ultrasonography in the detection of bladder tumors is examined. Of 49 bladder tumors 34 between 2 mm. and several centimeters in size could be demonstrated ultrasonographically. Ultrasound failed to visualize tumors less than 5 mm. in size in 14 patients. Dynamic transabdominal ultrasonography cannot replace cystoscopy in the diagnosis or followup of patients with bladder tumors but it may be used instead of cystoscopy in some selected cases.

Ultrasonographic-pathologic correlation of malignant hepatic masses.

Characterization of the source of hepatic malignancy would be useful in directing a patients workup, saving time and expense. We attempted to correlate the echographic appearance of malignant hepatic masses with the pathologic (44 patients) or clinical (1 patient) diagnosis in 45 consecutive patients scanned to evaluate this problem. In 31 patients the lesions were hyperechoic (28) or predominantly hyperechoic with central lucency. Of these lesions, 25 represented metastases from adenocarcinoma of the colon (17), pancreas (6), or unknown origin (2). Six patients with metastatic adenocarcinoma had predominantly echolucent lesions.Of the 14 malignancies of other histologic types, 6 were largely hyperechoic and could not be distinguished from adenocarcinoma metastases. No correlations could be drawn between the ultrasound patterns and the tumor source in this diverse group of malignancies.In eight patients receiving chemotherapy, sequential examinations failed to reveal any alteration in the echographic patterns of their lesions.These results indicate that the ultrasound appearance of hepatic malignancy lacks specificity in defining the organ of origin. Such factors as homogeneity, vascularity, or desmoplastic response may be more important than cell type in producing the echographic pattern.

Ultrasonically Guided Transperineal Biopsy in the Diagnosis of Prostatic Carcinoma

AbstractAn improved technique of ultrasonically guided transperineal biopsy of the prostate is presented in a consecutive series of 16 clinically suspicious cases of carcinoma. The biopsy could be obtained with a high degree of accuracy from any predetermined region of the prostate, and a definitive diagnosis was established from biopsy specimens in all 8 cases of verified cancer.

Endoluminal ultrasonic scanning in the staging of cervical carcinomas

A new method in the staging of cervical carcinomas using endoluminal rectal ultrasound scanning is demonstrated in the different staging.

Ultrasound in the diagnosis of a palpable abdominal mass. A prospective study of 107 patients.

In 107 consecutive patients referred to the ultrasound laboratory for investigation of a palpable abdominal mass, the examination was performed without knowledge of clinical history, laboratory findings, or the results of other examinations.In 101 of the patients the correct diagnosis was subsequently verified, and 29 different ultrasonic diagnoses were reached. In 98 (97%) of the patients the ultrasonic diagnoses were correct. Two uterine leiomyomas were erroneously diagnosed as ovarian in origin, and a massive adrenal carcinoma was misdiagnosed as a hepatic tumor.It is suggested that ultrasonic scanning is the method of choice in evaluating patients with a palpable abdominal mass.

Abdominal Ultrasonic Scanning Versus Lymphangiography in Testicular Cancer

Abdominal ultrasonic scanning was compared to lymphangiography and intravenous urography in 50 patients with testicular cancer. In 25 lymphangiographic stage I patients, the ultrasonic scanning was normal in all cases, too. In 5 out of 25 lymphangiographic stage II patients, the ultrasonic examination demonstrated a wider extension of the retroperitoneal metastases than combined lymphangiography and urography. The ultrasonically demonstrated masses were proven to contain malignant cells through an ultrasonically-guided fine-needle puncture in all 5 cases. Sufficient planning of the radiation ports would not have been possible in these patients without the additional ultrasonic scanning. In monitoring of the therapeutic response, ultrasonic scanning was found superior to lymphangiography.