Diagnosis of prostatic carcinoma: value of random transrectal sonographically guided biopsies.

Slonim, Suzanne M.; Cuttino, John T.; Johnson, Christopher; Yankaskas, Bonnie C.; Smith, Jordan; Silverman, Mark L.; Libertino, John A.

doi:10.2214/ajr.161.5.8273601

Cited by 21 publications

(13 citation statements)

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“…For group G1, B-scan values for prostate cancer detection are lower than other published studies (2,3,4) and this may be due to our stricter requirement of substantial 3D co-registration in order to qualify as a true positive. Comparison of in vitro transaxial scanning versus real-time biplanar transrectal ultrasound introduces another issue in that longer real-time imaging and imaging from more than one plane may improve lesion detection.…”

Section: Discussionmentioning

confidence: 58%

“…Many of the tumors in group G2 are physically too small to generate sonoelastic contrast at the frequencies we are currently using. In addition, as the size of the cancer approaches 0.1 cm 3 , we lack an understanding of the mechanical and elastic properties of the tumor and if there is sufficient mechanical contrast compared to surrounding tissues to make a detectable void on a sonoelastic image. It is possible that very small tumor stiffness may not be the same as larger tumors, but could be considerably less, especially as compared to background tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Transrectal sonography (TRUS) identifies only 64% of cancers per gland (2) and 32-42% of cancers per lobe (3,4). With random biopsy, up to 32% of cancers are missed when comparing biopsy results per lobe with prostatectomy specimens (3).…”

Section: Introductionmentioning

confidence: 99%

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Prostate Cancer: Three-dimensional Sonoelastography for in Vitro Detection

Taylor¹,

Rubens²,

Porter³

et al. 2005

Radiology

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PURPOSE: To prospectively evaluate the accuracy of 3D sonoelastography for detection of prostate cancer relative to gray scale sonography in vitro.METHODS: Using an Institutional Review Board-approved, HIPAA compliant protocol with informal consent, 19 prostatectomy specimens from patients 46 to 70 years of age with biopsy proven prostate cancer were scanned in 3D using conventional B-scan and sonoelastography using vibrations above 100Hz.Step-sectioned whole-mount histology was utilized to create a 3D volume of the prostate and tumors within it. B-scan ultrasound images and regions of low vibration in the sonoelastography images (hard regions) were formatted in 3D. The lesions in the nineteen cases were analyzed as two groups: G1) pathology-confirmed tumors of 1.0 cc or greater; and G2) pathology-confirmed tumor size less than 1.0 cc. G1 cases were evaluated for B-scan ultrasound and sonoelastography vs. histology as a reference standard and were scored as either a True Positive, a False Positive, a True Negative, or a False Negative. G2 cases were evaluated for sonoelastography only. True positives required 3D lesion correlation between pathology and imaging data. Conventional definitions of accuracy and sensitivity were employed to calculate these statistics. RESULTS: G1 (7 lesions with tumor volume 1.0 cc or greater): Sonoelastography: accuracy of 55%, sensitivity of 71%. B-scan: accuracy of 17%, sensitivity of 29%. Mean tumor size is 3.1cc +/-2.1cc. G2 (22 lesions with tumor volume less than 1.0 cc). Mean tumor size is 0.32 cc +/-0.21 cc. Sonoelastography: accuracy of 34%, sensitivity of 41%, false positives: 6.CONCLUSIONS: Sonoelastography performed considerably better than gray scale sonography in the detection of prostate cancer tumors over 1 cc.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Prostate Cancer: Three-dimensional Sonoelastography for in Vitro Detection

Taylor¹,

Rubens²,

Porter³

et al. 2005

Radiology

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“…In a number of the excluded systematic biopsy studies, certain cores taken at systematic biopsy were replaced by targeted biopsies if a suspicious area was close to that systematic biopsy site [56][57][58][59][60]. Thus, many studies represented a mix of systematic standard and hypoechoic lesion-targeted biopsies.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the diagnostic performance of systematic versus ultrasound-guided biopsies of prostate cancer

et al. 2006

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Transrectal ultrasound (TRUS) is an important tool for urologists and radiologists in the detection of prostate cancer. Various TRUS-guided biopsy techniques are applied in clinical practice. Frequently, only the detection rates achieved with these methods are compared. Other diagnostic performance parameters, particularly the specificity and negative predictive value, are seldom compared. After extensive assessment of the available literature, this review describes the methods of TRUS-guided biopsy for prostate cancer detection. A distinction was made between systematic biopsies and biopsies that target a perceived (hypoechoic or Doppler-enhancing) lesion on imaging. Subsequently, the diagnostic performance (sensitivity, specificity, positive and negative predictive values, accuracies) was compared between these techniques. Imaging-guided biopsy showed better diagnostic performance than systematic biopsy with higher sensitivity. The combinations of sensitivity and specificity were highest for colour Doppler and contrast-enhanced targeted biopsy. Studies targeting hypoechoic lesions had relatively high sensitivity, but specificity was low. Presently however, with widespread prostate-specific antigen screening, fewer prostate cancers are hypoechoic, and the value of targeting hypoechoic lesions has diminished. Performing colour or contrast-enhanced Doppler biopsy or adding these techniques to systematic biopsies improves diagnostic performance, particularly by increasing sensitivity.

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“…TRUS alone has a poor cancer detection rate (< 10%) [2,14], The precision of this method for the localization of the tumor is also poor as shown by Flanigan et al [5] with only 18% of suspicious regions having cancer while 65% of the cancerous regions were sonographically normal. This explains the absolute need to biopsy any suspicious lesion and to add random biopsies to increase the detec tion rate [15]. TRUS has been shown to be a poor infor mative tool between different practitioners and even when the exam is repeated by the same one.…”

Section: Analysis Of Abnormal Imagesmentioning

confidence: 99%