[The significance of focal hypoechoic lesions in the peripheral zone of the prostate].
Hypoechoic lesions in the peripheral zone of the prostate gland are one of the commonest abnormalities at transrectal ultrasonography (TRUS). 90% of all carcinomas originating in the peripheral zone present as a hypoechoic lesion. Hypoechogenicity though is not specific, as many benign lesions are also hypoechoic. In this retrospective study, based on TRUS alone 57% of the hypoechoic lesions showed carcinoma in the biopsy core (43% of the biopsy cores were benign). The number of positive biopsies increased up to 75% when the hypoechoic lesion was palpable at digital rectal examination. 5.2% of the hypoechoic cancers would have been missed when non-palpable lesions would not have had a biopsy. When the hypoechoic lesion was associated with increased serum concentration of prostate specific antigen (PSA > 4 ng/ml) 74% of the biopsies were positive. 20% to 25% of all hypoechoic cancers would not have had a biopsy. The positive predictive value was 85% when the hypoechoic lesion was palpable at digital rectal examination and the PSA-concentration was > 4 ng/ml (and 90% when volume-adjusted PSA-parameter would have been applied).
Oyen
R
R
Dienst Radiologie, Universitaire Ziekenhuizen, Katholieke Universiteit Leuven, Belgium.
Van Popel
H
H
Van de Voorde
W
W
Knapen
P
P
Ameye
F
F
Baert
A L
AL
Baert
L V
LV
D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D010173:Palpation; D017430:Prostate-Specific Antigen / Q000302:isolation & purification; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*
D017430:Prostate-Specific Antigen
De betekenis van een focaal hyporeflectief letsel in de perifere zone van de prostaat.