Sedelaar J P, van Roermund J G, van Leenders G L, Hulsbergen-van de Kaa C A, Wijkstra H, de la Rosette J J
Department of Urology, University Medical Center, St. Radboud, Nijmegen, The Netherlands.
Urology. 2001 May;57(5):914-20. doi: 10.1016/s0090-4295(00)01115-8.
To compare the accuracy of the detection, localization, and staging of prostate cancer using transrectal three-dimensional (3D) grayscale ultrasonography (3D-US) with conventional transrectal two-dimensional grayscale ultrasonography (2D-US).
Fifty patients with clinical localized prostate cancer scheduled to undergo radical retropubic prostatectomy and 50 patients with clinical benign prostatic hyperplasia underwent transrectal ultrasound investigations (2D and 3D). The prostate images were retrospectively analyzed by two ultrasound experts unaware of the clinical findings. The images of the prostate cancer group were correlated with the whole-mount histologic specimens of the prostate.
All percentages are given for experts 1 and 2. The sensitivity, specificity, and accuracy for the detection of prostate cancer without considering the definitive localization of the tumor for 2D-US was 72% and 76%, 50% and 54%, and 63% and 64%, respectively; for 3D-US, the rates were 82% and 88%, 40% and 42%, and 61% and 65%. The sensitivity, specificity, and accuracy of the combination of 2D-US with 3D-US was 88% and 90%, 36% and 38%, and 62% and 64%, respectively. The sensitivity, specificity, and accuracy for the exact localization of the prostate tumor for 2D-US was 44% and 46%, 50% and 54%, and 47% and 50%, respectively; for 3D-US, they were 52% and 62%, 40% and 42%, and 46% and 52%. The staging of prostate cancer using 3D-US was correct in 49% (expert 1) and in 57% (expert 2) of patients. No difference was observed between 2D-US and 3D-US for accurate staging. Both experts judged the interpretation of 3D-US images as superior to that of 2D-US images.
Although 3D-US had statistically significant increased sensitivity in the detection of lesions and decreased specificity compared with 2D-US, 3D-US did not result in significant clinical improvement in the detection and staging of prostate cancer.
比较经直肠三维（3D）灰阶超声检查（3D-US）与传统经直肠二维灰阶超声检查（2D-US）在前列腺癌检测、定位及分期方面的准确性。
50例计划行耻骨后根治性前列腺切除术的临床局限性前列腺癌患者和50例临床良性前列腺增生患者接受了经直肠超声检查（2D和3D）。由两位不知晓临床结果的超声专家对前列腺图像进行回顾性分析。前列腺癌组的图像与前列腺的全层组织学标本进行关联分析。
所有百分比数据均针对专家1和专家2给出。不考虑肿瘤确切定位时，2D-US检测前列腺癌的敏感性、特异性和准确性分别为72%和76%、50%和54%、63%和64%；3D-US的相应比率分别为82%和88%、40%和42%、61%和65%。2D-US与3D-US联合应用时的敏感性、特异性和准确性分别为88%和90%、36%和38%、62%和64%。2D-US对前列腺肿瘤精确定位的敏感性、特异性和准确性分别为44%和46%、50%和54%、47%和50%；3D-US的相应数据分别为52%和62%、40%和42%、46%和52%。使用3D-US对前列腺癌进行分期时，49%（专家1）和57%（专家2）的患者分期正确。在准确分期方面，2D-US和3D-US之间未观察到差异。两位专家均认为3D-US图像的解读优于2D-US图像。
尽管与2D-US相比，3D-US在病变检测方面敏感性有统计学意义的提高，但特异性降低，3D-US在前列腺癌的检测和分期方面并未带来显著的临床改善。
