ABSTRACT

It were aimed to evaluate the value of transrectal ultrasonography (TRUS) for the deter-mination of the cancer sites within the prostate gland in patients with prostate-specific antigen (PSA) values >20 ng/ml.

Fifty-one patients with PSA values > 20 ng/ml who underwent TRUS examination and TRUS-guided prostate biopsy were included to the study. Under TRUS guidance sextant plus lesion biopsies were taken from each patient. TRUS findings of each biopsy location were correlated with histopathological outcome.

In the analysis of 408 biopsy foci, sensitivity, specificity, positive and negative predicitive values of TRUS were 63.5%, 90.4%, 83.7% and 76.2% respectively. In total, 4 of 51 (7.84%) patients with nonsuspicious TRUS findings had prostate cancer, whereas there were nine (17.64%) patients with cancer foci determined at the contralateral side of the lesion detected by TRUS. In addition, there were 65 (15.9%) locations in which cancer foci were identified altough TRUS detected no lesion.

Diagnostic value of TRUS is not sufficiently high, even in PSA ranges > 20 ng/ml. Therefore, we suggest that systematic biopsies should also be performed in patients with PSA > 20 ng/ml in addition to the lesion biopsies.

Keywords: prostate cancer, transrectal ultrasonography, prostate specific antigen, biopsy