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Prostate carcinoma: transrectal US after cryosurgical ablation
C G Salomon1, C L Kalbhen, C M Dudiak
1Department of Radiology, Loyola University Medical Center, Maywood, IL 60153, USA.
Radiology
|February 11, 1998
Summary
Transrectal ultrasound (US) is unreliable for detecting residual prostate cancer after cryosurgical ablation. Focal lesions identified by US have low sensitivity and predictive value for residual tumor detection.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Cryosurgical ablation is a treatment for prostate cancer.
- Post-treatment monitoring is crucial for detecting residual disease.
Purpose of the Study:
- To evaluate transrectal ultrasound (US) findings in the prostate after cryosurgical ablation.
- To correlate US morphology with residual tumor detection via biopsy.
Main Methods:
- Review of 24 transrectal US exams in 15 patients post-cryosurgical ablation.
- Correlation of prospective US lesion identification and morphology with biopsy results.
Main Results:
- Transrectal US had low sensitivity (13%) and positive predictive value (17%) for residual tumor.
- US prostate morphology was frequently distorted and variable.
- US specificity was 69% and negative predictive value was 61%.
Conclusions:
- Focal lesions on transrectal US are not reliable indicators of residual prostate cancer post-ablation.
- Systematic biopsy is recommended even if US shows no focal abnormalities.
- Transrectal US findings alone should not guide decisions about further biopsies.