Journal of Ultrasound in Medicine, Vol 11, Issue 4 117-123, Copyright © 1992 by American Institute of Ultrasound in Medicine
Multiple criteria in sonographic diagnosis of prostatic carcinoma allows identification of all glands harboring clinically significant tumor: an in vitro study with histopathologic correlation
N. S. Hardt, J. V. Kaude, G. Tykochinsky, P. R. Ros, Z. Wajsman and R. L. Hackett
Department of Pathology, University of Florida College of Medicine, Gainesville 32610.
Fresh whole prostate glands were examined systematically in a water bath to
look for four sonographic criteria for prostatic carcinoma:
well-circumscribed hypoechoic regions, external asymmetry of the gland,
increase in anterior-posterior diameter ratio, and irregularity of the
prostatic capsule. Whole mount sections were examined to correlate the
histopathologic and sonographic findings. Using hypoechogenicity alone, 26
of 43 glands harboring tumor were identified correctly. Using all four
criteria, 40 of 43 glands harboring tumor were identified, a statistically
significant improvement in sensitivity (P less than 0.05). Specificity of
both methods was similar (P greater than 0.1). The three tumors that were
missed measured 0.5 x 0.5 x 0.5 cm, 0.5 x 0.5 x 0.5 cm, and 0.3 x 0.4 x 0.9
cm, and were found at autopsy in patients who died of causes unrelated to
the prostate. The authors conclude that systematic examination of the gland
with attention to multiple criteria for abnormality can improve case
finding in prostatic adenocarcinoma.
