Significance of Hypoechoic Lesion and Increased Blood Flow on Transrectal Ultrasound for Prostate Cancer Detection

Koo Han Yoo; Seung Hyun Jeon; Joo Won Lim; Sung-Goo Chang

doi:10.4111/kju.2007.48.2.138

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Yoo, Jeon, Lim, and Chang: Significance of Hypoechoic Lesion and Increased Blood Flow on Transrectal Ultrasound for Prostate Cancer Detection

Original Article

Korean Journal of Urology

Korean Journal of Urology 2007; 48(2): 138-142.

Published online: 28 February 2007

DOI: https://doi.org/10.4111/kju.2007.48.2.138

Significance of Hypoechoic Lesion and Increased Blood Flow on Transrectal Ultrasound for Prostate Cancer Detection

Koo Han Yoo, Seung Hyun Jeon, Joo Won Lim¹, Sung-Goo Chang

Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.

¹Department of Radiology, School of Medicine, Kyung Hee University, Seoul, Korea.

Corresponding author (sgchang@khu.ac.kr)

Received 14 September 2006 Accepted 26 October 2006

Abstract

Purpose

A hypoechoic lesion is the most common finding of prostate cancer, but its diagnostic value is still an area of debate. The diagnostic significance of a hypoechoic lesion and the increased blood flow observed on transrectal ultrasonography (TRUS) were evaluated for the detection of prostate cancer.

Materials and Methods

The records of 266 patient's, between January 2003 and December 2005, were retrospectively reviewed. The cancer detection rates were compared according to the presence of a hypoechoic lesion in TRUS, and estimated with respect to stratification of the prostatespecific antigen (PSA) value and digital rectal examination (DRE) findings.

Results

The overall cancer detection rate was higher in the hypoechoic (40 of 101 cases, 39.6%) than in the isoechoic group (30 of 157 cases, 19.1%) (p<0.05). When the cases were divided into three groups, according to their PSA level (<4, 4-10 and >10), the cancer detection rate apparently increased in those with a hypoechoic lesion in TRUS (10.3 vs. 0%, 25 vs. 13.6% and 68.2 vs. 31% respectively) (p<0.001). Furthermore, the cancer detection rate was further increased in patients with a hypoechoic lesion than in those with an isoechoic lesion after division into two groups according to the presence of a hard nodule on DRE (with hard nodule, 56.9 vs. 46.7%; without hard nodule, 20 vs. 8.1%, respectively) (p<0.05). However, hypoechoic lesions with an increased blood flow did not improve the detection rate compared to those without (p>0.05).

Conclusions

The hypoechoic finding on TRUS not only supports the detection of prostate cancer, but also has independent diagnostic value. However, the findings of color Doppler are not helpful in the detection of prostate cancer.

Keywords: Prostate cancer, Biopsy, Ultrasonography

Figures and Tables

Table 1

Patient characteristics

PSA: prostate-specific antigen

Table 2

Prostate cancer detection rates for hypoechoic lesions according to the serum PSA level

PSA: prostate-specific antigen, Pca: prostate cancer, ^*: 1 Pt - urothelial carcinoma, ^†: Fisher's exact test, ^‡: Cochran-Mantel-Haenszel test

Table 3

Prostate cancer detection rates for hypoechoic lesions according DRE

DRE: digital rectal examination, Pca: prostate cancer, ^*: Fisher's exact test, ^†: Cochran-Mantel-Haenszel test

Table 4

The prostate cancer detection rates for color flow increased with hypoechoic lesions

Pca: prostate cancer, ^*: Fisher's exact test

Notes

This study supported by the Brain Korea 21 project in 2006.

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