Follow-up of benign hypoechoic peripheral zone lesions of the prostate gland: US characteristics and cancer prevalence.
OBJECTIVE
To evaluate the role of biopsy-proved benign peripheral zone hypoechoic lesions of the prostate gland, ultrasonographic (US) characteristics at follow-up, prostate-specific antigen (PSA) levels, and digital rectal examination (DRE) in prediction of cancer risk.


METHODS
Retrospective analysis was performed for 105 consecutive patients with 148 benign hypoechoic lesions discovered at transrectal US (TRUS) and diagnosed with US-guided needle biopsy. At least one repeat TRUS study was performed in each patient.


RESULTS
Among the benign lesions, 72% changed at follow-up TRUS, either disappearing or becoming smaller, less hypoechoic, and more vague. Cancer developed in 13% of patients. In 93% of patients in whom cancer developed, the appearance changed in the peripheral zone at follow-up TRUS. In this patient population, the positive predictive value for development of cancer was 16% with a changing TRUS appearance, 19% with an abnormal DRE result, and 27% with an elevated level of PSA; only the latter was statistically significant.


CONCLUSIONS
The PSA value, alone or in combination with a changing TRUS appearance, is the best indicator for development of cancer.
Fogarty
K T
KT
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104.
Arger
P H
PH
Shibutani
Y
Y
Nodine
C F
CF
Tomaszewski
J E
JE
Coleman
B G
BG
Jacobs
J E
JE
Langer
J E
JE
Wein
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging*; D017430:Prostate-Specific Antigen / Q000032:analysis; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography
D017430:Prostate-Specific Antigen