Three-dimensional US of the prostate: Early experience

PURPOSE: To assess the feasibility of using a three-dimensional (3D) endore ctal transducer at ultrasonography (US) in the prostate gland in a clinical setting. MATERIALS AND METHODS: Sixteen patients underwent 3D imaging of the prostat e gland with a 3D endorectal probe following conventional two-dimensional ( 2D) US and prior to prostatic biopsy. Image acquisition was performed as a volume of data with nearly immediate reconstruction and simultaneous displa y of sectional anatomy in three orthogonal planes-sagittal plane, transvers e or coronal plane, or any arbitrary oblique plane. Images were evaluated f or presence of focal lesions, glandular volume, visualization of lateral an d anterior portion of the gland, and extraglandular extension of tumor. RESULTS: Three-dimensional US allowed better visualization of the gland and focal lesions, especially on the coronally reconstructed images, which wer e judged superior to the sagittally or transversely reconstructed images fo r interpretation in 50% of the patients. Prostatic volumes obtained from 3D US were consistently smaller than volumes obtained from 2D US (20% differe nce, P = .006). Three-dimensional US was superior to 2D US in depicting tum or presence (nine of 10 right hemispheres, three of eight left hemispheres) and extraglandular extend of disease (three of five hemispheres). CONCLUSION: Three-dimensional endorectal prostatic US appears to be clinica lly feasible and easy to perform. Added anatomic information from the coron al plane may allow better depiction of tumors and extraglandular spread tha n is possible with current 2D techniques.