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Correlation Between Prostatic Transrectal Ultrasound Findings and Biopsy Results

Author(s): Mohammad Kazem Tarzamni | Fariba Alizade

Journal: Iranian Journal of Radiology
ISSN 1735-1065

Volume: 6;
Issue: S1;
Start page: 108;
Date: 2009;
Original page

"nIntroduction: Prostate cancer is the most commonly diagnosed cancer in men, making this disease a significant public health issue. Unfortunately, the anatomic location of the prostate does not lend itself to straightforward examination. The advent and refinement of ultrasound technology have provided a new, important method to examine the prostate. Transrectal ultrasonography (TRUS) in conjunction with the development of serum assays for prostate-specific antigen (PSA) has resulted in an impressive change in the manner of diagnosis and stage presentation of men with prostate cancer. This study aims at evaluating the correlation between prostatic TRUS findings and results of biopsy. "nMaterials and Methods: In an analytic-descriptive study, 130 men referred to Tabriz Sheikholraeis Sonography Center for TRUS were evaluated during a 14-month period. These patients suffered from urinary symptoms and/or had a high level of serum PSA or an abnormal digital rectal examination. After evaluation with TRUS, TRUS-guided sextant biopsy was fulfilled in all patients and this method was considered as the gold standard. Volume and echo pattern of the prostate, as well as presence of nodules were focused during TRUS. "nResults: One hundred thirty men, with the mean age of 68.67±9.56 (47-90) years were enrolled. Based on the results of histopathologic examination, there were 72 (55.38%) cases with a malignant condition. The mean age of the patients with malignant disease, as well as the mean serum free and total PSA and PSA density was significantly higher than that in the group with nonmalignant disease. The mean serum free to total PSA was significantly higher in patients with nonmalignant conditions and there was no statistical difference between the two groups according to the volume of the prostate gland. The ROC curve analysis yielded the best sensitivity (88%) and specificity (88%) for PSA density at a cut-off point ≥ 0.26. The sensitivity and specificity of TRUS was 64.9% and 100%, respectively. These values were 72% and 100%, respectively in patients with PSA density ≥ 0.26. "nConclusion: According to our study, the combination of TRUS with determining the PSA density may result a 100% specificity in discrimination of malignant and nonmalignant conditions of the prostate; however, this method may still miss 28% of the patients with a malignant disease. So biopsy could not be replaced with any other procedure in this regard.   
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