Are Hypoechoic Lesions on Transrectal Ultrasonography a Marker for Clinically Significant Prostate Cancer?

Noh, Tae Il; Shin, Yoon Sun; Shim, Ji Sung; Yoon, Jong Hyun; Kim, Jae Heon; Bae, Jae Hyun; Moon, Du Geon; Park, Jae Young

doi:10.4111/kju.2013.54.10.666

Cited by 11 publications

(9 citation statements)

References 29 publications

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“…In our study, patients who had hypoechoic lesions on TURS had a higher Gleason Grade group than those who didn’t, especially for patients with PSA > 20 ng/ml. This result was consensus with other studies [ 30 ]. Ellis and Brawer [ 31 ] also confirmed that Gleason score was independent of ultrasound findings.…”

Section: Discussionsupporting

confidence: 93%

The predictive efficacy of hypoechoic lesion in ultrasound for prostate cancer in Chinese people: five-year experience in a moderated 10-core transperineal prostate biopsy procedure

et al. 2017

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We aim to investigate the predictive efficacy of hypoechoic lesion for prostate cancer at different levels of serum PSA in the procedure of transrectal ultrasound guided 10-core trans-perineal prostate biopsy (TP-PBx). In this study, we collected clinical parameters involving age, digital rectal examination (DRE), PSA, prostate volume, pathological diagnosis, Gleason score, novel Gleason group, and numbers of positive cores from 856 patients who had elevated level of PSA above 4 ng/ml or susceptible nodule of prostate gland in DRE received the moderated 10-core TP-PBx procedure. There were 481 cases (56.2%) with no visible lesion of hypoechoic nodule in transrectal ultrasound (TRUS) and 375 cases (43.8%) with the hypoechoic lesion. The total cancer detection rate is 45.56%. The predictive efficacy of hypoechoic lesion for prostate cancer varies among different PSA intervals. For PSA groups of 0–4, 4–10, 10–20, 20–100, > 100 ng/ml, the Youden’s indexes are 0.3483, 0.3506, 0.3941, 0.2795 and 0.8667, respectively. Besides, the visible lesions are inclined to be detected in patients with higher Gleason score. We concluded that the hypoechoic lesions in TRUS could improve the predictive accuracy for diagnosing prostate cancer and present different predictive efficacy in the respective PSA intervals. Besides, it was probably associated with more aggressive clinical significance.

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Section: Discussionsupporting

confidence: 93%

The predictive efficacy of hypoechoic lesion in ultrasound for prostate cancer in Chinese people: five-year experience in a moderated 10-core transperineal prostate biopsy procedure

et al. 2017

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“…We could also show that cancerous lesions with higher GS are more often visible than those with low grade PCa. Therefore, we share Noh et al opinion that all visible abnormalities should be biopsied, especially the hypoechoic lesions that can be seen as a marker for clinically significant PCa [16]. It is assumed that there is an association between PCa alterations in tissue composition and changes in MR images [17].…”

Section: Discussionsupporting

confidence: 54%

Visibility of MRI prostate lesions on B-mode transrectal ultrasound

et al. 2018

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Aim: Prostate biopsies are usually done with transrectal ultrasound (TRUS) in B-mode (B TRUS) but multiparametric MRI (mpMRI) is the gold imaging standard for the visualization of clinically significant prostate cancer (PCa), since a lowPCa detection rate is reported for B TRUS. The aim of this study was to assess the visibility of MRI lesions on B TRUS and to determine which factors may influence the visibility on B TRUS.Material and methods: 142 men with 148 lesions reported on mpMRI underwent a B TRUS/mpMRI fusion targeted biopsy of the prostate and were included in this retrospective study. During the biopsy, images were obtained and stored in the institution’s PACS. These images were reviewed by two radiologists to determine, whether an mpMRI lesion was or was not visible on B TRUS.Results: Overall 92 from 148 mpMRI lesions (62.2%) were visible on B TRUS. The location of the lesion in the prostate, the PIRADS classification of the lesions and the size of the lesion had no significant influence on the visibility on B TRUS. Only the prostate volume had a significant influence on visibility: in smaller prostates significantly more lesions were visible on B TRUS than in large glands (p+0.041; 45.1 ml vs 54 ml).Conclusion: The use of newer high-end ultrasound units as well as experience gained from fusion biopsies enables us to see 62.2 % of all suspicious mpMRI lesions on B TRUS. B TRUS images merit a thorough examination during a conventional biopsy setting.

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“…Indeed, a previous study has shown that a significant number of cancers (2.7-3.5%) would have been missed by TRUS-guided biopsy if the hypoechoic lesion had not been sampled [16]. In addition, previous studies have shown that a hypoechoic lesion on ultrasound was a marker of a more aggressive disease in patients with PC [17,18], stressing the need to sample this lesion. However, the number of cores that should be sampled is currently unknown for patients presenting a prostate hypoechoic lesion on ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Different Systematic Prostate Biopsy Methods in the Detection of Prostate Cancer with Ultrasonographic Hypoechoic Lesions - A Comparative Study

Yao²,

Wu³

et al. 2015

Urol Int

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Objective: To assess if a less extended biopsy in the transperineal approach is sufficient for detection of prostate cancer (PC) in patients with hypoechoic lesions. Methods: This was a prospective study of 167 consecutive patients with prostate hypoechoic lesion and who underwent transperineal ultrasound (TPUS)-guided 12-core and hypoechoic lesion core biopsy between January 2012 and February 2013. Results: PC was detected in 64.1% (107/167) of patients. The PC detection rate of the 12-core prostate biopsy scheme was the highest, but when including the hypoechoic lesion core, there was no difference between the 6- and 12-core schemes (all p > 0.05), irrespective of prostate volume or prostate-specific antigen levels (all p > 0.05). Conclusions: A more limited biopsy scheme could be sufficient for the detection of PC if the hypoechoic lesion is sampled.

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Are Hypoechoic Lesions on Transrectal Ultrasonography a Marker for Clinically Significant Prostate Cancer?

Cited by 11 publications

References 29 publications

The predictive efficacy of hypoechoic lesion in ultrasound for prostate cancer in Chinese people: five-year experience in a moderated 10-core transperineal prostate biopsy procedure

The predictive efficacy of hypoechoic lesion in ultrasound for prostate cancer in Chinese people: five-year experience in a moderated 10-core transperineal prostate biopsy procedure

Visibility of MRI prostate lesions on B-mode transrectal ultrasound

Diagnostic Value of Different Systematic Prostate Biopsy Methods in the Detection of Prostate Cancer with Ultrasonographic Hypoechoic Lesions - A Comparative Study

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