Radical prostatectomy: transrectal sonographic evaluation to assess for local recurrence.
OBJECTIVE
To determine sonographic features associated with locally recurrent or residual tumor.


METHODS
Twenty-three transcretal ultrasound (TRUS) studies were performed in 21 patients with suspected recurrent prostatic carcinoma after prostatectomy. The original prospective TRUS reports were reviewed, followed by blinded review, and the findings were compared with biopsy results.


RESULTS
A discrete perianastomotic mass was identified prospectively in eight (73%) of 11 patients with positive biopsy results and in two (17%) of 12 with negative results; no mass was identified in the remaining patients. At preliminary retrospective review, the echogenic retroanastomotic fat plane was not intact in 10 (91%) of 11 patients with positive biopsy results and in two (17%) of 12 with negative results; it was intact in the remaining patients.


CONCLUSIONS
Sonographic visualization of a mass in the prostate bed or loss of integrity of the retroanastomotic fat plane is strongly correlated with finding recurrent or residual tumor in this location. TRUS in evaluation of the source of postoperative evaluation of prostate-specific antigen levels warrants further investigation.
Salomon
C G
CG
Department of Diagnostic Radiology, Loyola University Medical Center, Marywood, IL 60153.
Flisak
M E
ME
Olson
M C
MC
Dudiak
C M
CM
Flanigan
R C
RC
Waters
W B
WB
D000368:Aged; D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015588:Observer Variation; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods
D017430:Prostate-Specific Antigen