Korean J Urol.  2007 Feb;48(2):138-142. 10.4111/kju.2007.48.2.138.

Significance of Hypoechoic Lesion and Increased Blood Flow on Transrectal Ultrasound for Prostate Cancer Detection

• Yoo KH
• Jeon SH
• Lim JW
• Chang SG

• KMID: 2139751
• DOI: http://doi.org/10.4111/kju.2007.48.2.138

Abstract

PURPOSE: A hypoechoic lesion is the most common finding of prostate cancer, but its diagnostic value is still an area of debate. The diagnostic significance of a hypoechoic lesion and the increased blood flow observed on transrectal ultrasonography (TRUS) were evaluated for the detection of prostate cancer.
MATERIALS AND METHODS
The records of 266 patient's, between January 2003 and December 2005, were retrospectively reviewed. The cancer detection rates were compared according to the presence of a hypoechoic lesion in TRUS, and estimated with respect to stratification of the prostate- specific antigen (PSA) value and digital rectal examination (DRE) findings.
RESULTS
The overall cancer detection rate was higher in the hypoechoic (40 of 101 cases, 39.6%) than in the isoechoic group (30 of 157 cases, 19.1%) (p<0.05). When the cases were divided into three groups, according to their PSA level (<4, 4-10 and >10), the cancer detection rate apparently increased in those with a hypoechoic lesion in TRUS (10.3 vs. 0%, 25 vs. 13.6% and 68.2 vs. 31% respectively) (p<0.001). Furthermore, the cancer detection rate was further increased in patients with a hypoechoic lesion than in those with an isoechoic lesion after division into two groups according to the presence of a hard nodule on DRE (with hard nodule, 56.9 vs. 46.7%; without hard nodule, 20 vs. 8.1%, respectively) (p<0.05). However, hypoechoic lesions with an increased blood flow did not improve the detection rate compared to those without (p>0.05). CONCLISIONS: The hypoechoic finding on TRUS not only supports the detection of prostate cancer, but also has independent diagnostic value. However, the findings of color Doppler are not helpful in the detection of prostate cancer.

Keyword

Prostate cancer; Biopsy; Ultrasonography

MeSH Terms

Biopsy
Digital Rectal Examination
Humans
Prostate*
Prostatic Neoplasms*
Retrospective Studies
Ultrasonography*

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