PROSTATE CANCER: THE ROLE OF TRANSRECTAL ULTRASOUND AND ITS IMPACT ON CANCER DETECTION AND MANAGEMENT
Section snippets
EPIDEMIOLOGIC AND CLINICAL ISSUES
Understanding diagnostic test performance requires a basic review of frequently used statistical parameters and their impact on decision making in the work-up of prostate cancer patients.
True positives=TP; false-positives=FP; true-negatives=TN; false-negatives=FN
Sensitivity = TP/(TP + FN)
Specificity = TN/(TN + FP)
Positive predictive value = TP/(TP + FP)
Negative predictive value = TN/(TN + FN)
Accuracy = (TP + TN)/(TP + FP + TN + FN)
Sensitivity is thus primarily driven by false-negatives,
Technique
The advent of high-frequency transducers provided the necessary improvement in spatial resolution to allow a detailed view of internal prostate anatomy. The majority of papers published before 1986 used ultrasound transducers operating at 3.5 and 4 MHz. These images of the prostate produced criteria for cancer, which relied on the evaluation of the external contours of the gland for asymmetry, prostate diameter, and distortion of the capsule.6, 31 With newer 5- and 7-MHz transducers, the basic
SUMMARY
With the advent of higher-frequency transducers as well as Doppler technologies, TRUS has become a valuable tool in the detection and management of prostate cancer. When combined with the other risk identifiers, an informed patient, and an experienced operator, it cannot only reduce the number of missed cancers by effective targeting of biopsies, but also reduce the number of unnecessary biopsies.
ACKNOWLEDGMENTS
The authors express their thanks to Kyle Meetz, BS, and Faith Howard, BA, for their assistance in the preparation of this manuscript.
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Address reprint requests to Peter J. Littrup, MD, Department of Radiology, Harper Hospital, 3990 John R., Detroit, MI 48201, e-mail: [email protected]