Transrectal ultrasound findings in patients with advanced prostate cancer

Objectives : The objective is to determine transrectal ultrasound (TRUS) findings and their relevance in the diagnosis of prostatic cancer among patients with abnormal digital rectal examination (DRE) and elevated PSA. Materials and Methods : This was a prospective study of 131 patients suspected to have advanced prostate cancer based on clinical presentation, abnormal DRE and elevated PSA (>10 ng/ml), who were evaluated with TRUS prior to prostatic biopsy and the findings correlated with the histologic outcome. Results : The mean prostate size by TRUS was 66.8 g with a range of 15-219 g. The majority of patients with hypoechoic nodules 56.3% (45 of 80) had a malignant histology and the yield was higher among those with both hypoechoic nodules and prostatic capsule invasion 25 (31.3%). Cancer detection in those with mixed echogenicity was next in frequency 33.8% (27 of 80). All the prostates with hyperechoic pattern and most of those with isoechoic appearance had benign histology. Conclusion : Though TRUS findings generally have a low specificity for prostate cancer, the specificity of TRUS findings is probably higher in advanced prostate cancer.