OBJECTIVES: To estimate the incidence of transrectal ultrasound (TRUS) hyperechoic lesions and of hyperechoic prostate cancer in TRUS-guided biopsy specimens. METHODS: We prospectively studied 200 patients with total prostate-specific antigen values less than 20 ng/mL and/or positive results on digital rectal examination who had undergone TRUS-guided prostate biopsy. Each patient underwent laterally directed systemic six-core biopsy plus cores from abnormal TRUS lesions and rectally palpable lesions. Six to 10 biopsy cores were obtained from each patient. RESULTS: Hyperechoic lesions were found in 19 patients (9.5%), hypoechoic in 83 (41.5%), and isoechoic in 98 (49.0%). Prostate cancer was diagnosed in 33.0% of study patients. Isoechoic findings on TRUS were recorded in 31.8% of patients diagnosed with prostate cancer, whereas 60.6% of cancers had hypoechoic and 7.6% hyperechoic lesions. There was no significant difference in the mean Gleason score between isoechoic cancers (mean 5.4) and hypoechoic cancers (mean 5.6). However, hyperechoic cancers had a mean Gleason score of 7.0, which was higher when compared with isoechoic and hypoechoic cancers. CONCLUSIONS: Biopsy of hyperechoic lesions was positive for prostate cancer in a higher percentage of patients than previously reported in the literature, and Gleason score of these cancers was higher when compared with isoechoic and hypoechoic cancers.
OBJECTIVES: To estimate the incidence of transrectal ultrasound (TRUS) hyperechoic lesions and of hyperechoic prostate cancer in TRUS-guided biopsy specimens. METHODS: We prospectively studied 200 patients with total prostate-specific antigen values less than 20 ng/mL and/or positive results on digital rectal examination who had undergone TRUS-guided prostate biopsy. Each patient underwent laterally directed systemic six-core biopsy plus cores from abnormal TRUS lesions and rectally palpable lesions. Six to 10 biopsy cores were obtained from each patient. RESULTS:Hyperechoic lesions were found in 19 patients (9.5%), hypoechoic in 83 (41.5%), and isoechoic in 98 (49.0%). Prostate cancer was diagnosed in 33.0% of study patients. Isoechoic findings on TRUS were recorded in 31.8% of patients diagnosed with prostate cancer, whereas 60.6% of cancers had hypoechoic and 7.6% hyperechoic lesions. There was no significant difference in the mean Gleason score between isoechoic cancers (mean 5.4) and hypoechoic cancers (mean 5.6). However, hyperechoic cancers had a mean Gleason score of 7.0, which was higher when compared with isoechoic and hypoechoic cancers. CONCLUSIONS: Biopsy of hyperechoic lesions was positive for prostate cancer in a higher percentage of patients than previously reported in the literature, and Gleason score of these cancers was higher when compared with isoechoic and hypoechoic cancers.
Authors: David Bonekamp; Michael A Jacobs; Riham El-Khouli; Dan Stoianovici; Katarzyna J Macura Journal: Radiographics Date: 2011 May-Jun Impact factor: 5.333
Authors: Rachel Sparks; B Nicolas Bloch; Ernest Feleppa; Dean Barratt; Daniel Moses; Lee Ponsky; Anant Madabhushi Journal: Med Phys Date: 2015-03 Impact factor: 4.071