Correlation between pre-radical prostatectomy standardized SUVmax ratios detected on 68Ga-PSMA-I&T PET/CT and final histopathology outcomes: an in-depth analysis.

OBJECTIVE: To evaluate the predictive potential of the maximum standardized uptake value(SUVmax) value of intraprostatic tumors derived from preoperative 68Ga-PSMA-I&T PET/CT (SUVT), and its ratios to SUVmax in the liver (SUVTLR) and parotid gland (SUVTPR) with respect to histopathological findings. MATERIALS AND METHODS: Data from patients who underwent radical prostatectomy (RP) for prostate cancer (PC) at our clinic between 2017 and 2020 were assessed. Patients with a secondary malignancy, a history of transurethral prostate resection, prior treatment for PC, or who received salvage RP were excluded. Whole-body images obtained using the same device, as per the guidelines, were reviewed by two nuclear medicine specialists with more than a decade of experience to reach a consensus for each lesion. The relationships between age, PSA, Prostate Volume, clinical T stage, biopsy International Society of Urological Pathology grade (ISUP), D'amico risk group, intraprostatic tumor volume (HPTV) identified in the final histopathological specimen review, HP-ISUP grade, seminal vesicle invasion (SVI), extracapsular invasion (ECI), positive surgical margine (PSM), SUVT, SUVTLR, and SUVTPR were analyzed. RESULTS: The mean age of the 64 included patients was 64.1 ±â€¯5.3. A statistically significant correlation was found between SUVT, SUVTLR, SUVTPR values, and histopathologic stage parameters, such as biopsy ISUP, D'amico Risk Classification, HP-ISUP, HPTV (p < 0.05). PSMATV, SUVT, and SUVTLR were statistically significant predictors of extracapsular invasion, while PSA, PSMATV, and SUVTLR were significant predictors of SVI (p < 0.05). CONCLUSION: The standardized SUVT, SUVTLR, and SUVTPR values could be employed as noninvasive markers to assist in predicting postoperative histopathological findings, particularly ECI, SVI, and PSM.

Spontaneous vaginal delivery in the birth-chair versus in the conventional dorsal position: a matched controlled comparison.

AIM: The aim of the study was to assess the effect of a birth-chair on obstetric outcome. PATIENTS AND METHODS: We reviewed the hospital records of 220 consecutive pregnant women who gave birth on a birth-chair at our institution. The control group consisted of 440 pregnant women who preceded and followed the index cases and who had spontaneous vaginal deliveries in the conventional dorsal supine position. The controls were matched for parity and for the attending mid-wife. RESULTS: Patients who delivered in the birth-chair had significantly lower rates of episiotomy and manual separation of the placenta. The umbilical blood cord pH was significantly higher in neonates of the birth-chair group. The duration of labour, rate of perineal and vaginal injury, Apgar scores and rate of admission to a neonatal intermediate care unit were not influenced by the mode of delivery. CONCLUSION: Our data support previous studies that a birth-chair delivery may be a safe alternative to conventional delivery in the supine position.

Malignancy arising in extraovarian endometriosis during estrogen stimulation.

OBJECTIVE: Endometriosis can undergo estrogen-dependent changes similar to endometrium and may carry a risk of developing hyperplasia and carcinoma during unopposed estrogen stimulation. MATERIAL-METHOD: We reviewed the existing literature to analyze the potential of a malignancy arising from extraovarian endometriosis by estrogen stimulation. RESULTS: To our knowledge, there are 20 published cases so far, with a malign transformed endometriosis during estrogen stimulation at an extraovarian site. The most common site of malignancy arising from endometriosis was the vagina (n = 5). The most common histological finding was adenocarcinoma (n = 13). The incidence of malignant transformation in extraovarian endometriosis during unopposed estrogen replacement can not be estimated based upon these case reports. CONCLUSION: Unopposed estrogen stimulation may lead to premalignant or malignant transformation in the residual foci of endometriosis. Therefore, the addition of progestins to estrogen replacement therapy should be considered in women who have undergone hysterectomy with oophorectomy because of endometriosis, especially if they are known to have residual endometriosis.

Pregnancies in patients with premature ovarian failure.

We present 5 women with premature ovarian failure (POF) who were treated with different regimes and conceived. Three patients conceived spontaneously while on cyclic estrogen/progestagen replacement therapy. One patient conceived after high-dose gonadotrophin treatment. Embryo transfer with oocytes donated from a third party donor was performed in one patient abroad. Due to legal reasons the heterogeneous oocyte donation for patients with POF cannot be performed in some countries such as Austria. Therefore, many patients who desire pregnancy cannot receive optimal treatment for their condition.

Contrast sonography for inconclusive findings on routine sonography.

OBJECTIVES: We conducted a pilot study in 20 women with sonographically suspect endometria, to assess the value of contrast sonography and patient acceptance of this procedure. METHODS: Saline solution 4-20 ml was injected into the uterine cavity using an embryo transfer catheter, followed by hysteroscopy in 19 cases and hysterectomy in one case. RESULTS: A polyp was diagnosed in 12 patients, a submucous myoma in one patient, a proliferated endometrium in five patients and a placental polyp in one patient. A sonographic irregular structure was diagnosed in one patient which turned out to be coagula on hysteroscopy and histology. The procedure was well accepted by all patients. The diagnosis found by contrast sonography agreed in all cases with that found by hysteroscopy. CONCLUSION: Our results show that contrast sonography is an easy, quick and inexpensive procedure which increases the diagnostic value of vaginal sonography. The indications for contrast sonography are based on inconclusive sonographic findings, especially if polyps or submucous myoma are suspected.

[Diagnostic value of combined vaginal ultrasound and hysteroscopy in peri- and postmenopausal bleeding]. / Aussagekraft der kombinierten Anwendung von Vaginalsonographie und Hysteroskopie bei peri-und postmenopausalen Blutungen.

OBJECTIVE: Is it possible to reduce the rate of curettages by using ultrasound and hysteroscopy? METHODS: Transvaginal sonography, hysteroscopy, and dilation and curettage were performed in 103 patients with menometrorrhagia or postmenopausal bleeding. The patients were divided into three groups, depending on the ultrasound findings. RESULTS: All 9 cases with cancer of the endometrium were found in group 3. 1 of the 9 carcinomas was not detected by hysteroscopy. CONCLUSIONS: We believe that dilation and curettage is necessary in symptomatic women with an endometrial thickness < 4 as well as > 4 mm. Prospective studies have to clear the question of whether endometrial carcinomas can be detected by hysteroscopy in cases with an endometrium < 4 mm thick.