飯田 明男

Akio IIDA

京都府立医科大学泌尿器科学教室

Department of Urology, Kyoto Prefectural University of Medicine

キーワード : Biopsy, Interventional ultrasound, Prostatic cancer, Seminal vesicles

My colleagues and I developed an original ultrasonically guided puncture system that uses interventional ultrasound in 1979. This system has been applied to aspiration biopsy of the seminal vesicles since 1981, and it has been used since 1989 in a biopsy system that uses an 18-gauge needle driven by a spring-loaded biopsy gun and is guided by a transrectal real-time linear scanner. Biopsy of the bilateral seminal vesicles was performed in 101 cases of prostatic cancer from March 1989 to February 1995. Satisfactory biopsy specimens were obtained from 81 (80%) of the 101 cases, in which 40 (49%) cases of cancer invasion were proved histologically. No major complications were encountered with the procedure. Findings from transrectal sonography and palpation were in agreement with results of biopsy 79% and 62% of the time, respectively. Transrectal sonography had a sensitivity of 73% and a specificity of 85%. Coincidence rate of seminal-vesicle biopsy and findings from the excised specimen was 90% in 10 cases of radical prostatectomy. No case had a positive seminal-vesicle biopsy when serum PSA (prostate-specific antigen) level was less than 10 ng/ml. We found histologic examination of biopsy specimens of the seminal vesicle to be a direct and reliable way to evaluate cancer invasion.