Trans-rectal Ultrasound for Prostate Cancer

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A research investigation navigating over a period of twelve months was planned to include patients in whom there was an apprehension of malignancy of prostate and for whom biopsy was suggested. Prior to undertaking a biopsy and short of going through PSA levels, the patients underwent trans-rectal ultrasonography; the latter was carried out by two proficient radiologists so as to hunt doubtful lumps. Only those sores were measured as doubtful that were compact and gave off few echoes, so long as there was agreement between the two radiologists.

The conclusions were as follows:

  1. Methodical sonography estimation with precise consideration to the peripheral region (where greatest prostate lumps are located) should be done prior to the tissue removal for biopsy.
  2. In the presence of a doubtful lump, a collective approach of biopsy should be accepted. This is done by gathering specimen from all prostate samples (used as a standard of reference) complemented by focused biopsy of the sonographically doubtful lumps. 

The Main Disadvantage:

The small sensitivity of sonography estimation to identify nodular lumps in malignant cases continues to be the main disadvantage. It is imperative to keep in view that even if a prostate US measures normal, it cannot avoid a biopsy in cases where it is needed. However, at the same time, it is not desirable to endorse merely the approval of planned biopsy of nodular lumps. The recognized methodology of all prostate samples ought to be used as a standard of reference. 

Additional Approaches:

It is vital to investigate other lines of attack to intensify its diagnostic precision with approaches e.g.

  1. Doppler
  2. Contrast-enhanced ultrasonography 
  3. Elastography.

Also, it will be paramount to review how MRI findings could be used to mend the accuracy of ultrasound- directed biopsy.

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