Capsular transgression of prostatic carcinoma: evaluation with transrectal US with pathologic correlation

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• Prostate cancer staging is crucial for treatment planning.
• Accurate assessment of extracapsular extension (ECE) impacts surgical and oncological outcomes.
• Transrectal ultrasonography (US) is a noninvasive imaging modality for evaluating prostate anatomy.

Purpose of the Study:

• To evaluate the efficacy of biplane transrectal ultrasonography (US) in detecting capsular transgression of prostate cancer.
• To correlate US findings with pathological examination in patients undergoing radical prostatectomy.

Main Methods:

• Biplane transrectal ultrasonography (US) was performed on 125 patients with clinical stage A or B prostate cancer.
• Sonograms were analyzed for signs of capsular penetration, including contour deformity and periprostatic fat echo abnormalities.
• US findings were correlated with detailed pathological examination of prostate step sections.

Main Results:

• Pathological examination confirmed capsular penetration in 86 out of 250 prostate hemispheres.
• US correctly identified pericapsular tumor spread in 59 of these 86 hemispheres.
• US demonstrated a moderate correlation between diagnosed spread and pathological depth of penetration, with a 70.6% sensitivity and 91.5% specificity for detecting ECE.

Conclusions:

• Transrectal ultrasonography (US) is an effective noninvasive tool for detecting the presence of prostate cancer.
• US findings correlate with pathological assessment of capsular penetration, aiding in preoperative staging.