Transrectal Ultrasound Versus Digital Rectal Examination for the Staging of Carcinoma of the Prostate: Results of a Prospective, Multi-Institutional Trial

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1997Transrectal Ultrasound Versus Digital Rectal Examination for the Staging of Carcinoma of the Prostate: Results of a Prospective, Multi-Institutional Trial Joseph A. Smith, Peter T. Scardino, Martin I. Resnick, Alberto D. Hernandez, Steven C. Rose, and Marlene J. Egger Joseph A. SmithJoseph A. Smith , Peter T. ScardinoPeter T. Scardino , Martin I. ResnickMartin I. Resnick , Alberto D. HernandezAlberto D. Hernandez , Steven C. RoseSteven C. Rose , and Marlene J. EggerMarlene J. Egger View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65079-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the accuracy of transrectal ultrasonography versus digital rectal examination in staging the local extent of biopsy proved carcinoma of the prostate. Materials and Methods: A National Institutes of Health funded network was developed to perform prospective, multi-institutional trials. A total of 386 patients judged by the investigators to be candidates for radical prostatectomy underwent transrectal ultrasonography with recording of data according to a numerical analog for construction of receiver operating characteristic curves. The results of digital rectal examination were similarly recorded. After radical prostatectomy whole mount histology was performed on all surgical specimens, and pathological findings were correlated with preoperative transrectal ultrasound and digital rectal examination results. Results: The calculated area under the curve for transrectal ultrasound in predicting extra-capsular tumor extension was 0.69 compared to 0.72 for digital rectal examination (p = 0.64), while that for predicting seminal vesicle invasion was 0.74 and 0.69, respectively (p = 0.36). There was a nonstatistically significant trend for improved accuracy of both examinations as tumor volume increased. Transrectal ultrasound was more accurate for staging posterior cancers than for those in the anterior portion of the prostate. Conclusions: Neither transrectal ultrasound nor digital rectal examination proved to be superior to each other for staging the local extent of prostate cancer. No imaging modality or examination that depends on gross architectural changes is likely to have a high degree of accuracy in detecting microscopic extension of extracapsular tumor frequently observed in radical prostatectomy specimens. References 1 : A new approach for testing the significance of differences between ROC curves measured from correlated data. In: Information Processing in Medical Imaging. Edited by . The Hague: Martinus Nijhuff1984: 432. Google Scholar 2 : The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology1982; 143: 29. 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Google Scholar Departments of Urology, Vanderbilt University, Nashville, Tennessee, Baylor College of Medicine, Houston, Texas and Case Western Reserve University, Cleveland, Ohio, and Divisions of Urology and Family and Preventive Medicine, University of Utah, Salt Lake City, Utah© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byCOAKLEY F, QAYYUM A and KURHANEWICZ J (2018) Magnetic Resonance Imaging and Spectroscopic Imaging of Prostate CancerJournal of Urology, VOL. 170, NO. 6S, (S69-S76), Online publication date: 1-Dec-2003.Hricak H (2018) EDITORIAL: IMAGING PROSTATE CANCERJournal of Urology, VOL. 162, NO. 4, (1329-1330), Online publication date: 1-Oct-1999.GARG S, FORTLING B, CHADWICK D, ROBINSON M and HAMDY F (2018) STAGING OF PROSTATE CANCER USING 3-DIMENSIONAL TRANSRECTAL ULTRASOUND IMAGES: A PILOT STUDYJournal of Urology, VOL. 162, NO. 4, (1318-1321), Online publication date: 1-Oct-1999.ZLOTTA A, DJAVAN B, PETEIN M, SUSANI M, MARBERGER M and SCHULMAN C (2018) PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR PREDICTING PATHOLOGICAL STAGE OF LOCALIZED PROSTATE CANCER IN PATIENTS WITH SERUM PROSTATE SPECIFIC ANTIGEN LESS THAN 10 NG./ML.Journal of Urology, VOL. 160, NO. 6 Part 1, (2089-2095), Online publication date: 1-Dec-1998.Resnick M, Smith J, Scardino P, Egger M, Hernandez A and Rose S (2018) Transrectal Prostate Ultrasonography: Variability of InterpretationJournal of Urology, VOL. 158, NO. 3, (856-860), Online publication date: 1-Sep-1997. Volume 157Issue 3March 1997Page: 902-906 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Joseph A. Smith More articles by this author Peter T. Scardino More articles by this author Martin I. Resnick More articles by this author Alberto D. Hernandez More articles by this author Steven C. Rose More articles by this author Marlene J. Egger More articles by this author Expand All Advertisement PDF downloadLoading ...