[Prostate cancer: palpation versus ultrasonography]

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Prostate cancer diagnosis relies on various methods, including physical examination and imaging.
• Ultrasound (USG) offers different modalities for prostate assessment: transabdominal and transrectal.
• Comparing the diagnostic efficacy of these methods is crucial for clinical practice.

Purpose of the Study:

• To compare the diagnostic effectiveness of palpation, transabdominal ultrasound (USG), and transrectal ultrasound (USG) for prostate carcinoma.
• To evaluate the accuracy of each diagnostic method against histopathological findings.

Main Methods:

• A comparative study involving symptomatic patients undergoing prostate examinations.
• Group 1: Palpation vs. transabdominal USG (n=273).
• Group 2: Palpation vs. transrectal USG (n=162).
• Histopathological correlation was obtained for a subset of patients (n=203).

Main Results:

• Prostate cancer was confirmed in 25.3% of patients.
• Transrectal USG demonstrated higher sensitivity (97.7%) and overall accuracy (92.6%) compared to palpation (75.4% sensitivity, 84.2% accuracy) and transabdominal USG (78.3% sensitivity, 87.2% accuracy).
• Transrectal USG improved cancer staging accuracy for T2 and T3 tumors.
• USG had limitations in diagnosing incidental cancers in patients with benign prostatic hyperplasia (BPH).

Conclusions:

• Transrectal USG is a highly effective diagnostic tool for prostate cancer, surpassing palpation and transabdominal USG in accuracy.
• USG can aid in more precise cancer staging.
• Transrectal USG is recommended as a screening tool following digital rectal examination and Prostate-Specific Antigen (PSA) testing.