Correlation of transrectal ultrasound, computer analysis of transrectal ultrasound and histopathology of radical prostatectomy specimen

Abstract

A system for computerised analysis of ultrasonographic prostate images (AUDEX Automated Urologic Diagnostic EXpert system) for the detection of prostate carcinoma was developed. The ultimate goal is to develop a system that is reliable and non-observer dependent. Results of an earlier study with a small group were encouraging and this study describes the results of the computerised analysis in a larger group. Sixty-two patients who were scheduled to undergo a radical prostatectomy were prospectively analysed. The radical prostatectomy specimens were step-sectioned in the transverse plane, corresponding to the ultrasound pictures. Malignant regions identi®ed by each study were quanti®ed and compared by computer calculation. No correlation was observed between ultrasound analysis and pathology result. For the AUDEX analysis an overall sensitivity of 85% and a speci®city of 18% with only a diagnostic accuracy of 57% was noticed when presence or absence of malignancy was evaluated by octant (total 496). When applying a cut-off value of 0.5 ml the numbers were 71%, 33% and 55%, respectively. Correlation was signi®cantly better for the ventral octants. In this study the earlier results of our AUDEX system could not be con®rmed. Although sensitivity was good, speci®city and especially diagnostic accuracy were lower than expected. We have to conclude that the current settings are inappropriate for routine clinical use. Prostate Cancer and Prostatic Diseases (2001) 4, 56±62.

Prostate Cancer: Diagnostic Performance of Real-time Shear-Wave Elastography

“…Conventional transrectal US has limited sensitivity and specificity ranging from 40% to 50% for cancer detection (26)(27)(28). Other transrectal US techniques, such as contrast materialenhanced US, are currently being evaluated (29,30).…”

A survey of prostate modeling for image analysis

“…In addition, TRUS is widely used for needle biopsies and for guiding manipulations in subsequent treatments, such as brachytherapy and HIFU and laser therapies. TRUS helps to ensure that specific parts of the prostate are sampled or targeted, but its role in identifying tumor foci is very limited [11]. Currently, MRI is the gold standard for the morphometric evaluation of the prostate because it provides the best depiction of both the gland contours and the internal zonal anatomy.…”

Molecular Imaging in Early Detection of Cancer

“…87 Its drawback, however, is the limited usefulness to delineate cancer foci. [88][89][90] In clinics, TRUS is mainly employed to guide prostate biopsies to ensure an all-aspect sampling, and the sensitivity of TRUS-guided sextant biopsy for cancer detection is around 60%. 87 In one clinical trial, a total of 286 patients with suspected prostate cancer were subjected to evaluation studies with TRUS prostate biopsy and the sextant biopsy technique, 91 and the results indicated that the application of TRUS could significantly improve the detection rate of biopsy.…”