Comparative study of suprapubic sonography and computed tomography for staging of prostatic carcinoma

In addition to the digital rectal examination, suprapubic transvesical ultrasonography and computed tomography were used to stage local tumor extension in 41 patients with histologically proven prostatic carcinoma. Although 22% of the cases revealed stage A/B disease on rectal examination, these numbers were 7% for ultrasonography and 37% for CT. For stage C/D disease the percentages were 73% for digital rectal staging, 81% for sonography, and 30% for CT. Compared with the digital examination, 22% versus 10% of the cases had to be upstaged by the results of ultrasound versus CT. A downstaging became necessary by sonography in 7% and by CT in 44%. The results are compared with the findings after prostatectomy, autopsy, and cystoscopy as well as with pathohistological data from the literature. From these results, suprapubic transvesical sonography is considered to be more reliable than CT for local tumor staging.