title: The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions.
abstract: OBJECTIVE
  The present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies.
  
  
  METHODS
  Prospective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers). Sextant biopsy was subsequently performed. In cases of finding suspicious nodules, an additional puncture directed to such nodules was done.
  
  
  RESULTS
  In a total of 155 cases the prevalence of malignancy was of 53%. Suspicious nodules were detected in 34 patients, and 25 where malignant (positive predictive value of 74%). The specificity and sensitivity for suspicious nodules were 88% and 31% respectively. Comparatively with the randomly obtained sextant specimens, the rate of findings of neoplasia was higher in the specimens obtained with puncture directed to the nodule (p = 0.032). No statistically significant difference was observed in the Gleason score for both types of specimens (p = 0.172).
  
  
  CONCLUSIONS
  The high positive predictive value and the high rate of findings of neoplasia in specimens of suspicious nodules should be taken into consideration in the future. The authors suggest a biopsy technique similar to the one described in the present study (sextant biopsy plus puncture directed to the suspicious nodule).
authors: Intern Physician, Unit of Radiology, Hospital Distrital de Santarém, Santarém, Portugal.
authors: Pedro Marinho
authors: PM
authors: Lopes
authors: Intern Physician, Unit of Urology, Centro Hospital de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
authors: Luís
authors: L
authors: Sepúlveda
authors: MDs, Radiologists, Centro Hospital de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
authors: Rui
authors: R
authors: Ramos
authors: MDs, Radiologists, Centro Hospital de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
authors: Pedro
authors: P
authors: Sousa
keywords: Biópsia dirigida por imagem; Diagnostic techniques and procedures; Imaging-guided biopsy; Neoplasia prostática; Prostatic neoplasia; Rastreamento; Screening; Técnicas e procedimentos diagnósticos; Ultrasonography; Ultrassonografia