The Incidence of Hyperechoic Prostate Cancer in Transrectal Ultrasound–Guided Biopsy Specimens

Spajić, Borislav; Eupic, Hrvoje; Tomas, Davor; Štimac, Goran; Krušlin, Božo; Kraus, Ognjen

doi:10.1016/j.urology.2007.06.1092

Cited by 32 publications

(25 citation statements)

References 28 publications

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“…At transrectal US, most prostate cancers (60%-70%) are hypoechoic to the normal peripheral zone, whereas up to 40% of lesions are not distinguished from the background normal parenchyma owing to its isoechogenicity (8). Evaluation of the transition zone with transrectal US is very limited.…”

Section: Transrectal Us and Guided Biopsymentioning

confidence: 99%

Advancements in MR Imaging of the Prostate: From Diagnosis to Interventions

Bonekamp¹,

Jacobs²,

El-Khouli³

et al. 2011

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Prostate cancer is the most frequently diagnosed cancer in males and the second leading cause of cancer-related death in men. Assessment of prostate cancer can be divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. Magnetic resonance (MR) imaging has been shown to be of particular help in localization and staging of prostate cancer. Traditional prostate MR imaging has been based on morphologic imaging with standard T1-weighted and T2-weighted sequences, which has limited accuracy. Recent advances include additional functional and physiologic MR imaging techniques (diffusionweighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer. In addition, improvements in MR imaging hardware and software (3-T vs 1.5-T imaging) continue to improve spatial and temporal resolution and the signal-to-noise ratio of MR imaging examinations. Another recent advancement in the field is MR imaging guidance for targeted prostate biopsy, which is an alternative to the current standard of transrectal ultrasonographyguided systematic biopsy. Abbreviations: ADC = apparent diffusion coefficient, BPH = benign prostatic hyperplasia, DCE = dynamic contrast-enhanced, DRE = digital rectal examination, EES = extracellular-extravascular space, PSA = prostate-specific antigen, ROI = region of interest, SNR = signal-to-noise ratio, TKCM = tracer kinetic compartmental model

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Section: Transrectal Us and Guided Biopsymentioning

confidence: 99%

Advancements in MR Imaging of the Prostate: From Diagnosis to Interventions

Bonekamp¹,

Jacobs²,

El-Khouli³

et al. 2011

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216

161

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“…However, the advent of prostate-specific antigen (PSA) and high-frequency ultrasound transducers has led to an era of early prostate cancer detection, and prostate cancers have been recognized to have variable echotextures. Spajic et al [9] reported that 60.6% of prostate cancers involved hypoechoic lesions and 31.8% involved isoechoic lesions. The sole basis of TRUS echogenicity fell in importance for determining prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

Focal lesion at the midline of the prostate on transrectal ultrasonography: take it or leave it?

et al. 2017

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PurposeThe purpose of this study was to analyze the detection rate of prostate cancers from targeted biopsy specimens of midline focal lesions and to investigate the ultrasonographic findings to reduce unnecessary additional targeted biopsies.MethodsNinety-eight men with midline focal lesions detected on transrectal ultrasonography were enrolled. Additional targeted biopsies for midline focal lesions were performed after 12-core random systematic biopsies. Correlations between the ultrasonographic characteristics of midline focal lesions and the pathologic results were analyzed.ResultsTwenty of 98 targeted biopsy cores (20.4%) were positive for malignancy. In a univariate analysis, midline focal lesions without bulging contours (P=0.023), with involved margins (P=0.001), without hypoechoic perilesional rims (P=0.005), and with longer diameters (P=0.005) were statistically significant for cancer detection. In a multivariate analysis, involved margin (P=0.027), having longer diameter (P=0.011) or absence of hypoechoic perilesional rim (P=0.025) made a statistically significant contribution to cancer detection.ConclusionBiopsy of midline focal lesions was not always non-significant in the detection of prostate cancer. Additional targeted biopsies should be considered in cases of midline focal lesions with involved margins but without hypoechoic perilesional rims.

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“…Up to 40% of prostate cancer lesions is isoechoic on TRUS making lesions difficult to target. 3 Due to these limitations, 30% of men who has a prostate biopsy will undergo a repeat procedure. 4 Magnetic resonance imaging (MRI) is better able to visualize prostate cancer lesions.…”

Section: Introductionmentioning

confidence: 99%