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[Ultrasonography and prostatic adenocarcinoma]
F Grasso-Leanza1, P Pepe, P Panella
1Servizio di Urologia, Presidio Ospedaliero Cannizzaro, Ussl N. 36, Catania.
Summary
Transrectal ultrasonography shows high sensitivity for detecting prostate cancer but low specificity. Future plans involve monitoring patients with hypoechoic zones without other indicators, rather than immediate biopsy.
Area of Science:
- Urology
- Diagnostic Imaging
Background:
- Transrectal ultrasonography (TRUS) is utilized for early prostate cancer detection.
- Prostatic heteroplasia diagnosis requires accurate imaging and biopsy correlation.
Purpose of the Study:
- To evaluate the role of TRUS in the early diagnosis of prostatic heteroplasia.
- To assess the sensitivity, specificity, and diagnostic efficiency of TRUS in identifying prostate abnormalities.
Main Methods:
- A study involving 1185 patients with dysuria from January 1991 to January 1995.
- Patients underwent rectal exploration, Prostate-Specific Antigen (PSA) testing, and TRUS.
- Echoguided prostatic biopsies were performed on 306 patients.
Main Results:
- Hypoechoic zones were detected in 238 of 306 biopsied patients (77.7%).
- Histology confirmed adenocarcinoma in 81 patients (26.4%), benign prostatic hypertrophy in 196 (64%), and inflammation in 29 (9.4%).
- TRUS demonstrated 100% sensitivity, 30.2% specificity, and 48.6% diagnostic efficiency for prostatic heteroplasia. Hypoechoic zones were not always indicative of malignancy.
Conclusions:
- TRUS exhibits high sensitivity but limited specificity for diagnosing prostatic heteroplasia.
- Future strategy: Monitor patients with isolated hypoechoic zones (without elevated PSA or other pathology) via regular clinic checks instead of immediate biopsy.