Transrectal ultrasound of the prostate: innovations and future applications.
OBJECTIVE
We present a critical evaluation of the use of ultrasound for prostate disease examination in urological practice, and provide perspectives on ultrasound applications that may become important for the future evaluation of prostate problems.


METHODS
Based on an evaluation of clinical data in cases suspicious for prostatic malignancy, we addressed the apparent shortcomings of transrectal ultrasound for accurately diagnosing prostate cancer. Future applications presented in the literature were noted.


RESULTS
Evaluating the ultrasound data in cases suspicious for malignancy indicated that imaging has little advantage over digital rectal examination for detecting malignant areas. The new applications of ultrasound that hold great promise for use in the urology clinic include the injection of contrast agents to obtain information on blood supply, temperature estimation for the noninvasive assessment of temperature distributions during heat treatment and a therapeutic application for local treatment of prostate cancer.


CONCLUSIONS
While differential diagnosis with ultrasound appears to result in disappointing sensitivity and specificity values, its use in volume measurement and biopsy guidance is unquestioned. The development of new applications may improve the clinical value of ultrasound in urological practice. The application of ultrasound contrast agents for the detection and clinical staging of prostate cancer is especially promising. Future research will indicate whether the promise evolves in clinical applications.
Aarnink
R G
RG
Department of Urology, University Hospital Nijmegen, The Netherlands.
Beerlage
H P
HP
De La Rosette
J J
JJ
Debruyne
F M
FM
Wijkstra
H
H
D000818:Animals; D001831:Body Temperature; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging*; D017430:Prostate-Specific Antigen; D011469:Prostatic Diseases / Q000000981:diagnostic imaging*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging; D011472:Prostatitis / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
D017430:Prostate-Specific Antigen