Transrectal sonography of benign and malignant prostatic lesions

Using linear-array transrectal prostate sonography, malignant lesions in 43 patients and benign lesions in 74 patients were evaluated. Prostate sonography was sensitive to textural changes produced by both benign and malignant diseases. However, there was considerable overlap in the sonographic appearances of benign and malignant lesions, and there were no sonographic features that reliably predicted malignancy. Hyperechoic areas were present in 58% of the carcinomas, while 19% were purely hypoechoic. Lesions containing hypoechoic foci that were posterior or posterolateral had a high incidence of cancer. The results confirm the need to biopsy all suspicious palpable lesions of the prostate.