Transrectal ultrasound imaging of the prostate: review and perspectives ofrecent developments

We present a critical review of the recent literature and discuss the devel opment and prospective view of the evaluations of transrectal ultrasound wi th regard to prostate malignancy. We illustrate this with personal experien ces. Material and Methods: Based on a critical evaluation of clinical data we address the apparent shortcoming of greyscale transrectal ultrasonograph y in the assessment of prostate cancer. New developments and future possibi lities are also discussed. Evaluation of the value of greyscale transrectal ultrasonography in the dia gnosis of prostate cancer indicates a limited role, because of the non-unif orm appearance of prostate cancer on the ultrasound images. Ameliorating of transrectal ultrasound, like the use of contrast ultrasonography, could im prove the detection of prostate cancer. Although the use of greyscale transrectal ultrasonography lacks sensitivity and specificity for the diagnosis of prostate cancer, its use in volume me asurement of the prostate and biopsy guidance is unquestionable. The first results of the application of contrast ultrasonography are promising, both in detection of prostate cancer as in treatment follow up. Other developmen ts like improvement of transducer and computer technology could make the us e of ultrasound more versatile. However, future research will indicate whet her all these improvements will lead to clinical applications.