ObjectiveThe present study was aimed at evaluating the contribution of transrectal prostate
ultrasound in the screening for prostate neoplasias and in the guidance of
prostate biopsies.Materials and MethodsProspective study developed over a one-year period. All the patients with
indication for prostate biopsy were evaluated. Regardless of PSA values, the
patients underwent ultrasound in order to identify suspicious nodules (confirmed
by two observers). Sextant biopsy was subsequently performed. In cases of finding
suspicious nodules, an additional puncture directed to such nodules was done.ResultsIn a total of 155 cases the prevalence of malignancy was of 53%. Suspicious
nodules were detected in 34 patients, and 25 where malignant (positive predictive
value of 74%). The specificity and sensitivity for suspicious nodules were 88% and
31% respectively. Comparatively with the randomly obtained sextant specimens, the
rate of findings of neoplasia was higher in the specimens obtained with puncture
directed to the nodule (p = 0.032). No statistically significant
difference was observed in the Gleason score for both types of specimens
(p = 0.172).ConclusionThe high positive predictive value and the high rate of findings of neoplasia in
specimens of suspicious nodules should be taken into consideration in the future.
The authors suggest a biopsy technique similar to the one described in the present
study (sextant biopsy plus puncture directed to the suspicious nodule).
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