OBJECTIVES: To determine the accuracy of contrast-enhanced transrectal ultrasonography for tumor size measurements of hypoechoic prostate cancer foci located in the peripheral zone.
METHODS: A total of 55 men scheduled for radical prostatectomy, with biopsy-proven cancer in hypoechoic foci located in the peripheral zone, were consecutively enrolled in the present prospective study. Each patient underwent grayscale ultrasound and contrast-enhanced transrectal ultrasonography of the prostate according to a standardized protocol. The maximum tumor diameter on grayscale imaging and contrast-enhanced transrectal ultrasonography was compared with that determined using histopathology.
RESULTS: A mean underestimation was documented to be approximately 3.9 mm and 0.6 mm for grayscale and contrast-enhanced transrectal ultrasonography imaging, respectively. Grayscale and contrast-enhanced transrectal ultrasonography imaging underestimated measurements by 76.67% (46 of 60) and 48.33% (29 of 60), whereas overestimated measurements were 20% (12 of 60) and 26.67% (16 of 60), respectively. A strong correlation was observed between contrast-enhanced transrectal ultrasonography and histopathological measurements (r = 0.91, P < 0.0001). A weak linear correlation was found between grayscale and histopathological measurements (r = 0.59, P < 0.0001). Bland-Altman analysis results were in complete accordance with correlation analysis results. For cases with maximum histopathological tumor diameters ≤ 10 mm and >10 mm, 40% (6 of 15) and 86.67% (39 of 45) were index tumors, respectively (P < 0.0001).
CONCLUSIONS: Contrast-enhanced transrectal ultrasonography is significantly more accurate than conventional grayscale imaging for measuring prostate tumor size, especially for tumors with a diameter >10 mm, and it might have a role in preoperative assessment of prostatic index tumor sizes.
Written by:
Qi TY, Chen YQ, Jiang J, Zhu YK, Yao XH, Qi J. Are you the author?
Department of Ultrasonography, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Reference: Int J Urol. 2013 Mar 31. Epub ahead of print.
doi: 10.1111/iju.12125
PubMed Abstract
PMID: 23551612
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