TRANSRECTAL ULTRASOUND OF THE PROSTATE - INNOVATIONS AND FUTURE APPLICATIONS

Purpose: We present a critical evaluation of the use of ultrasound for prostate disease examination in urological practice, and provide pers pectives on ultrasound applications that may become important for the future evaluation of prostate problems. Materials and Methods: Based o n an evaluation of clinical data in cases suspicious for prostatic mal ignancy, we addressed the apparent shortcomings of transrectal ultraso und for accurately diagnosing prostate cancer. Future applications pre sented in the literature were noted. Results: Evaluating the ultrasoun d data in cases suspicious for malignancy indicated that imaging has l ittle advantage over digital rectal examination for detecting malignan t areas. The new applications of ultrasound that hold great promise fo r use in the urology clinic include the injection of contrast agents t o obtain information on blood supply, temperature estimation for the n oninvasive assessment of temperature distributions during heat treatme nt and a therapeutic application for local treatment of prostate cance r. Conclusions: While differential diagnosis with ultrasound appears t o result in disappointing sensitivity and specificity values, its use in volume measurement and biopsy guidance is unquestioned. The develop ment of new applications may improve the clinical value of ultrasound in urological practice. The application of ultrasound contrast agents for the detection and clinical staging of prostate cancer is especiall y promising. Future research will indicate whether the promise evolves in clinical applications.