PROSTATE CARCINOMA - TRANSRECTAL US AFTER CRYOSURGICAL ABLATION

PURPOSE: To characterize the transrectal ultrasound (US) morphology of the prostate after cryosurgical ablation and correlate these findings with the detection of residual tumor at transrectal US-directed biops y. MATERIALS AND METHODS: Findings from 24 transrectal US examinations in 15 patients (age range, 63-75 years) who had undergone cryosurgica l ablation of the prostate were reviewed. Prospective identification o f focal lesions with transrectal US and retrospective review of US pro state morphology were correlated with clinical data and transrectal US -directed biopsy results. RESULTS: Identification of a focal lesion wi th transrectal US yielded a sensitivity of 13%, specificity of 69%, po sitive predictive value of 17%, and negative predictive value of 61% f or the detection of residual carcinoma. US prostate morphology was var iable and distorted in the majority of cases. CONCLUSION: Identificati on of focal lesions with transrectal US is not a reliable criterion fo r the detection of residual tumor in the prostate after cryosurgical a blation. Systematic biopsy should not be deferred owing to lack of tra nsrectal US identification of focal abnormalities in patients with app ropriate clinical indications.