The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions

Abstract

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).

Assessment of the value of the different variants of abnormal digital rectal examination finding in predicting carcinoma of the prostate: a preliminary report of a two-center study

“…Of the 26 men who had a suspicious nodule in the prostate as a sole finding in this study, only 6 (23.1%) had adenocarcinoma giving a PPV of 23.1 despite the additional targeted biopsies. In the work of Lopes et al [11] out of 34 men with suspicious nodules, 25 (74%) were, however, adenocarcinoma, a sharp contrast to our finding. This may be a regional, racial or interobserver difference probably related to the differences in prevalence of the above-mentioned cofounders.…”

The use of long non-coding RNAs as prognostic biomarkers and therapeutic targets in prostate cancer

“…This shows that approximately 1 man in 7 will be diagnosed with PCa during his lifetime [ 1 ]. Because these numbers are similar throughout different regions of the world, PCa is expected to be one of the most serious medical challenges in the coming years [ 2 ]. PSA levels and digital rectal examination (DRE) are the main methods for early detection of PCa, and the prostate biopsy is considered the gold standard in patients with suspected PCa after DRE or when PSA levels are increased [ 3 ].…”

Predictive Value of Transrectal Ultrasound in the Diagnosis of Prostate Cancer

“…This is because of the advances in ultrasound machine technology and intracavitary transducers with increasingly higher frequencies. 8 However, the role of TRUS in the detection of suspicious lesions has been brought to question by some authors in their publications with some actually regarding TRUS as being only useful as a guide for prostate biopsy. 9,10 TRUS is a procedure that uses sound waves to create a video image of the prostate gland.…”