Staging of prostate cancer using 3-dimensional transrectal ultrasound images: A pilot study

Purpose: We used conventional transrectal ultrasound images for 3-dimension al (D) reconstruction of the prostate, and determined its value in staging clinically localized prostate cancer. Materials and Methods: A total of 36 patients with newly diagnosed clinical ly localized prostate cancer were studied. All patients underwent conventio nal transrectal ultrasonography with 3-D reconstruction. Images were examin ed and analyzed blindly, and findings were compared to histopathological st aging following radical prostatectomy. Results: Pathological staging of specimens revealed 15 sites of extracapsul ar extension in 10 patients, of whom 8 had positive margins and 2 had semin al vesicle invasion. The 3-D imaging identified 12 sites of extracapsular e xtension in 9 patients with 80% sensitivity, 96% specificity and 90% positi ve predictive value. Of the 2 patients with seminal vesicle invasion 1 was identified correctly on 3-D images; Overall staging accuracy of 3-D imaging was 94%. Conclusions: The 3-D reconstruction of conventional transrectal ultrasonogr aphy imaging is superior to 2-D imaging for staging localized prostate canc er. However, this advantage relies entirely on the visibility of prostate c ancer lesions on conventional ultrasonography. Further studies are warrante d to evaluate this technology for the management of prostate cancer.