Transrectal ultrasound in the diagnosis of prostate cancer: State of the art and perspectives

Objectives: Trans recta I ultrasound (TRUS) is an important tool in diagnos ing prostate cancer. However, specificity and sensitivity of conventional g rey-scaleTRUS for the detection of prostate cancer are disappointingly low. New ultrasound modalities are designed to overcome the disappointing resul ts and improve the use of ultrasound in the diagnosis of prostate cancer. T his work is a review of the recent literature, combined with own experience s. Methods:The papers were collected using a Medline search, combined with som e papers by author selection. The terms used for the Medline search include d among other things: transrectal ultrasound, prostate, prostate cancer, pr ostate biopsies, colour Doppler ultrasound, power Doppler ultrasound, contr ast ultrasound. The authors used their own experiences for illustrations of various techniques. Results and Conclusions: Although several modalities show a significant imp rovement in sensitivity and specificity for the detection of prostate cance r, none of the TRUS modalities discussed can replace prostate biopsies as a definitive diagnostic. Several techniques, especially contrast ultrasound, show definitive promise. However, two valid conclusions can be made from t he data presented. First: with today's technology, none of the TRUS modalit ies discussed can replace systemic biopsies in the early detection of prost ate cancer. Second: none of the discussed TRUS modalities has found a defin itive place in routine clinical-practice. Copyright (C) 2001 S. Karger AG, Basel.