title: [The significance of focal hypoechoic lesions in the peripheral zone of the prostate].
abstract: 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).
authors.affiliation: Dienst Radiologie, Universitaire Ziekenhuizen, Katholieke Universiteit Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Oyen
authors.forename: H
authors.initials: H
authors.lastname: Van Popel
authors.forename: W
authors.initials: W
authors.lastname: Van de Voorde
authors.forename: P
authors.initials: P
authors.lastname: Knapen
authors.forename: F
authors.initials: F
authors.lastname: Ameye
authors.forename: A L
authors.initials: AL
authors.lastname: Baert
authors.forename: L V
authors.initials: LV
authors.lastname: Baert
mesh_terms: 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*
chemical_list: D017430:Prostate-Specific Antigen
vernacular_title: De betekenis van een focaal hyporeflectief letsel in de perifere zone van de prostaat.