title: Significance of suspicious lesions at transrectal ultrasonography in men with serum prostate-specific antigen levels of < 20 ng/ml.
abstract: OBJECTIVE
  The objective of the study was to evaluate the significance of suspicious lesions at transrectal ultrasonography for prostate cancer diagnosis.
  
  
  METHODS
  A total of 1,009 men with a mean age of 65.0 +/- 7.7 years (range, 40.0-79.0) constituted the study cohort and 265 (26.3%) were diagnosed with prostate cancer on initial biopsy.
  
  
  RESULTS
  The cancer detection rate was higher in patients with suspicious lesions (33.2%) than in those with no suspicious lesion (21.5%) (P < 0.001). Pathologic findings of the needle biopsy samples also showed more aggressive characteristics in men with suspicious lesions (P < 0.05). Of 413 men with suspicious lesions, additional lesion-directed biopsies were performed in 133 patients. The positive predictive value of additional lesion-directed biopsy was 18.0%. Of patients who had positive cores on lesion-directed biopsies, all were also found to have positive cores on random biopsies, and no patient had positive cores only on lesion-directed biopsies. The Gleason score was not changed by the findings of lesion-directed biopsies in these patients.
  
  
  CONCLUSIONS
  Our findings do not provide a rationale to recommend the addition of lesion-directed biopsy in patients with suspicious lesions at transrectal ultrasonography. However, men with suspicious lesions at transrectal ultrasonography had a higher risk of being diagnosed with prostate cancer.
authors.affiliation: Department of Urology, Seoul Veterans Hospital, Seoul, Korea.
authors.forename: Hong Bang
authors.initials: HB
authors.lastname: Shim
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Hyoung Keun
authors.initials: HK
authors.lastname: Park
authors.forename: Ja Hyeon
authors.initials: JH
authors.lastname: Ku
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000592:standards*
chemical_list: D017430:Prostate-Specific Antigen