The value of three-dimensional transrectal ultrasonography in staging prostate cancer

To use three-dimensional transrectal ultrasonography (3D-TRUS) to reconstruct the prostate, and thus determine its value in staging clinically localized prostate cancer.

In all, 180 patients with newly diagnosed clinically localized prostate cancer were assessed using 3D-TRUS for staging. TRUS findings were compared with histopathological staging after radical prostatectomy.

Pathological staging of specimens showed extracapsular extension in 69 patients, of whom 53 had pathological capsular perforation and 16 had seminal vesicle invasion. 3D-TRUS identified 58 patients with sites of extracapsular extension with 84% sensitivity, 96% specificity, 94% positive predictive value, 91% negative predictive value and an overall accuracy of 92%. Of the 16 patients with seminal vesicle invasion 14 were identified correctly on 3D-TRUS. Overall the 3D-TRUS staging sensitivity was 84%, specificity 96%, positive predictive value 93%, negative predictive value 91% and accuracy 91%.

3D-TRUS seems to be an accurate technique for staging localized prostate cancer. If 3D-TRUS indicates locally advanced disease, the probability of capsular perforation or seminal vesicle invasion is very high.