Hypoechoic lesions of the prostate: clinical relevance of tumor size, digital rectal examination, and prostate-specific antigen.

Abstract

Two hundred fifty-six patients with hypoechoic lesions of the prostate found at transrectal ultrasound (US) were evaluated with prostate-specific antigen (PSA) study, digital rectal examination (DRE), and US-guided transrectal biopsy. Positive predictive values for cancer were calculated for transrectal US alone and in combination with DRE, PSA study, or both. Results were correlated with lesion size. The positive predictive value for transrectal US alone was 41%; this value increased to 61% if the patient had positive results from DRE, 52% if the PSA level was elevated, and 71% if both the DRE results and PSA level were abnormal. The positive predictive value for transrectal US fell to 24% if results of the DRE were normal, 12% if the PSA level was normal, and 5% if both DRE results and PSA level were normal. No cancers were detected in lesions 1.0 cm or smaller if DRE results and PSA level were normal. DRE and PSA study are valuable complements to abnormal transrectal US examinations. Biopsy of small suspicious lesions may not be indicated if results of both of the studies are normal.

Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

“…Its incidence has been increasing because of improvements in diagnostic testing, increasing life expectancy, and the presence of environmental carcinogens [1,2]. Although sonography has wisely been used for evaluating the prostate, many reports have shown the limitations of sonography for cancer detection based on its unsatisfactory sensitivity and variable accuracy [3][4][5][6][7][8].…”

“…Its incidence has been increasing because of improvements in diagnostic testing, increasing life expectancy, and the presence of environmental carcinogens [1,2]. Although sonography has wisely been used for evaluating the prostate, many reports have shown the limitations of sonography for cancer detection based on its unsatisfactory sensitivity and variable accuracy [3][4][5][6][7][8].Over the past few years, microbubble contrast-enhanced sonography has been introduced as a promising tool that can improve prostate cancer detection. Halpern et al [1], in an early large study, showed significant improvement of the sensitivity from 38% on gray-scale and color or power Doppler sonography to 65% with contrast-enhanced (CE) sonography.…”

Transrectal ultrasound imaging of the prostate: review and perspectives of recent developments

“…Despite its relatively high sensitivity, its speci®city has been consistently low (20 ± 60%). 31 We found a sensitivity of 84% and a speci®city of 67% using TRUS in the detection of prostate cancer. 30 This is the main reason that grey scale TRUS has limited applicability in screening for prostate cancer.…”

Computer-aided Prostate Cancer Detection using Texture Features and Clinical Features in Ultrasound Image

“…In this research, the brightness of the tissue is used as a texture feature. 7 In addition to brightness, multiresolution autocorrelation coeffcients in two dimensions are used. Figure 4 shows the concept of autocorrelation, and its coefficients have shapes like in Figure 5.…”