DIAGNOSIS OF PROSTATIC-CARCINOMA - VALUE OF RANDOM TRANSRECTAL SONOGRAPHICALLY GUIDED BIOPSIES

OBJECTIVE. We studied the efficacy of random, transrectal sonographica lly guided biopsies in the diagnosis of prostatic carcinoma in a high- risk population.SUBJECTS AND METHODS. During a 2-year period, 570 tran srectal sonographically guided prostatic biopsies were done because of clinical findings suggestive of prostatic carcinoma. Biopsies of hypo echoic lesions that were suggestive of carcinoma and segmental random biopsies of normal-appearing lobes of the prostate were performed. Tra nsrectal sonographic findings were correlated with results of patholog ic examination of the biopsy specimen and with surgical results, when available. RESULTS. Of the 202 patients found to have carcinoma, the c arcinoma was detected with directed biopsy in 145 patients (72%). One hundred twenty (71%) of 169 carcinomas were detected with random biops y when that procedure was performed. Random biopsies were the only met hod of diagnosing 57 (28%) of the 202 carcinomas, increasing the yield by 39%. CONCLUSION. Yield of carcinoma on transrectal sonographically guided biopsies increases significantly when segmental random biopsie s are performed. Transrectal sonographically guided biopsies should in clude cores through hypoechoic lesions that are suggestive of carcinom a and bilateral segmental random biopsies.