Transrectal Ultrasound in the Diagnosis of Prostate Cancer: State of the Art and Perspectives

Sedelaar, J.P. Michiel; Vijverberg, P.L.M.; Reijke, T.M. De; Rosette, Jean J.M.C.H. de la; Kil, Paul; Braeckman, Johan; Hendrikx, Ad J.M.

doi:10.1159/000049787

Cited by 57 publications

(44 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because TRUS biopsy often fails to determine the location of prostate cancer, repeated random biopsies are considered by many authors to represent the standard method for prostate cancer detection. Even so, the false-negative biopsy rate remains unacceptably high at 30–40% [29,30,31]. 11 C-choline PET may provide more accurate information regarding the localization of main primary prostate cancer lesions than MRI or MR spectroscopy by using endorectal coil (fig.…”

Section: The Role Of Positron Emission Tomography or Positron Emissiomentioning

confidence: 99%

The Roles of PET and PET/CT in the Diagnosis and Management of Prostate Cancer

et al. 2007

View full text Add to dashboard Cite

2-¹⁸F-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) imaging in prostate cancer is challenging because glucose utilization in well-differentiated prostate cancer is often lower than in other tumor types. Nonetheless, FDG-PET has a high positive predictive value for untreated metastases in viscera, but not lymph nodes. A positive FDG-PET can provide useful information to aid the clinician’s decision on future management in selected patients who have low prostate-specific antigen levels and visceral changes as a result of metastases. On the other hand, FDG-PET is limited in the identification of prostate tumors, as normal urinary excretion of radioisotope can mask pathological uptake. Moreover, there is an overlap in the degree of uptake between prostate cancer, benign prostatic hyperplasia and inflammation. The tracer choice is also important. ¹¹C-choline has the advantage of reduced urinary excretion, and thus ¹¹C-choline PET may provide more accurate information on the localization of main primary prostate cancer lesions than MRI or MR spectroscopy. ¹¹C-choline PET is sensitive and accurate in the preoperative staging of pelvic lymph nodes in prostate cancer. A few studies are available but there were no PET or PET/CT studies with a large number of patients for tissue confirmation of prostate cancer; further investigations are required.

show abstract

Section: The Role Of Positron Emission Tomography or Positron Emissiomentioning

confidence: 99%

The Roles of PET and PET/CT in the Diagnosis and Management of Prostate Cancer

et al. 2007

View full text Add to dashboard Cite

show abstract

“…A number of computerized programs have recently been developed for the elaboration of color signals in 3-D echography, which seem to allow a better sensitivity and an improved reproduction. [12][13][14][15][16][17] In our experience, only in one patient with PCa, DRE and TRUS within normal limits and an increased total PSA, the CDU after Levovist s revealed a better sensitivity compared to the standard sonography; in all the other patients, DRE and/or TRUS, in addition to total and free/total PSA, were always positive.…”

Section: Discussionmentioning

confidence: 94%

Does the adjunct of ecographic contrast medium Levovist® improve the detection rate of prostate cancer?

Pepe

Patanè

Panella

et al. 2003

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Objectives: To evaluate whether the adjunct of an ultrasound contrast medium improves the detection rate of prostate cancer. Method: In 34 patients, scheduled to undergo a trans-perineal extended prostate biopsy, we carried out a color-Doppler ultrasound (CDU) of the prostate before and after i.v. injection of Levovist s , an ultrasound contrast medium. Further bioptic samples were taken in the areas where a marked increase in vascularization was noticed. Results: The overall diagnostic sensitivity, specificity and efficiency were respectively 72.7, 56.2 and 62.9% for transrectal ultrasound (TRUS); 80, 56.2 and 65.3% for CDU and 88.8, 54.5 and 68% for CDU after Levovist s injection; 66.5, 72.6 and 65.1% for digito-rectal examination (DRE); 100, 51.4 and 65.4% for total PSA; and 100, 88.8 and 94.3% for PSA free/total. In the 16 patients with prostate carcinoma, the sensitivity of CDU after Levovist s was 92.3, 66% for both DRE and TRUS, and 80% for DRE plus TRUS. Conclusions: Considering the cost and the results obtained (high sensitivity and low specificity), a routine use of Levovist s does not seem indicated in patients undergoing prostatic biopsy. An exception may be represented by patients with both negative DRE and TRUS.

show abstract

“…Djavan et al [8] report a PCa incidence after the second, third, and fourth sextant biopsies in patients with a negative DRE and a PSA included between 4 and 10 ng/ml equal to 10, 5 and 4%, respectively. On the other hand, actual imaging means are not provided with suitable sensibility and specificity for the implementation of cores aimed in suspected zones; even if some authors suggest using the echographic contrast medium to increase the ultrasound diagnostic efficiency, at present there are conflicting results in literature [9,10]. Therefore, the adoption of extended TRUS-guided prostatic needle biopsy schemes with an increased number of cores on the peripheral portion and on the lateral margins of the gland constitutes, nowadays, the only suitable method to increase the PCa diagnosis considering; moreover, the homogenous incidence of neoplasia on the peripheral portion of the prostatic gland [11].…”

Section: Discussionmentioning

confidence: 99%

Prostate Needle Biopsy: 12 vs. 18 Cores – Is It Necessary?

Pepe¹,

Aragona²

2005

Urol Int

View full text Add to dashboard Cite

Introduction: The aim of this study is to compare the histological results of a prostate needle biopsy scheme of 12 and 18 cores used in 372 consecutive patients submitted to an early stage diagnosis programme for prostate cancer (PCa). Materials and Methods: From February 2002 to July 2003 a transperineal TRUS-guided prostate needle biopsy was performed in 372 patients aged 40–73. Indications for biopsy were: suspected DRE, total PSA (PSAt) >10 ng/ml; PSAt equal to 4–10, 2.6–3.9, ≤2.5 ng/ml and PSA F/T <25%, <20% and <15%, respectively. In 256 patients, we performed 12 cores and in 116 cases 18 cores. Results: 159 (42.7%) patients were diagnosed with PCa, 138 (37%) with BPH, 58 (15.7%) with chronic prostatitis, 15 (4%) with a HGPIN, 2 (0.6%) with ASAP. In patients that underwent 12 and 18 cores the incidence of PCa was 39.8 and 49%; the incidence of PCa in patients with PSA ≤10 and >10 ng/ml submitted to 12 and 18 cores was 35 vs. 47% and 57.8 vs. 52%, respectively. The preponderance of clinical stage T1c was 50% (12 cores) vs. 72% (18 cores). The median bioptic Gleason score in both groups resulted 6.6 (12 cores) and 6 (18 cores). In 110 (12 bioptic cores) and in 30 (18 bioptic cores) patients that underwent a RRP, the pTNM proved a significant clinical neoplasm (Gleason score ≧6 and/or tumoral volume >0.5 cm³) in the first group in all cases, while in the second group in 28/30 (94%) cases. Conclusions: Extended schemes of prostate needle biopsy of 18 or more cores increases the PCa diagnosis in early stage and should be adopted for young patients with a PSA <10 ng/ml, negative DRE and in case of rebiopsies.

show abstract

Transrectal Ultrasound in the Diagnosis of Prostate Cancer: State of the Art and Perspectives

Cited by 57 publications

References 60 publications

The Roles of PET and PET/CT in the Diagnosis and Management of Prostate Cancer

The Roles of PET and PET/CT in the Diagnosis and Management of Prostate Cancer

Does the adjunct of ecographic contrast medium Levovist® improve the detection rate of prostate cancer?

Prostate Needle Biopsy: 12 vs. 18 Cores – Is It Necessary?

Contact Info

Product

Resources

About