Analysis of sonographic pattern in prostatic cancer: comparison of longitudinal and transversal transrectal ultrasound with subsequent radical prostatectomy specimens.

Abstract

In this study the diagnostic accuracy of transrectal ultrasonography (TRUS) in identifying prostatic cancer has been investigated. Attention was paid to the localization of tumor, capsular penetration and involvement of seminal vesicles. TRUS was performed with a 5-mHz linear array longitudinal probe as well as with a 5-mHz rotating transverse scanner. 23 patients underwent radical prostatectomy. The histological results were compared with the sonographic patterns. Transverse TRUS and longitudinal TRUS were comparable with regard to all the investigated parameters. The sensitivity and specificity for the presence or absence of tumor were 70-75 and 54%, respectively. When suspicion of capsular involvement was estimated in a prostatic lobe, a sensitivity of 89% and a specificity of 21% was found. When every separate ultrasonographically suspicious area of capsular breach was considered, there was a positive correlation of 63%. Seminal vesicle infiltration is hard to identify and TRUS has a sensitivity of only 65-74% with a specificity of 40-57%.