Endorectal Color Doppler Sonography and Endorectal MR Imaging Features of Nonpalpable Prostate Cancer

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Abstract
OBJECTIVE. The purpose of this study was to describe endorectal sonography and color Doppler sonography features of nonpalpable prostate cancer and to assess the value of endorectal MR imaging for the preoperative local staging of these tumors.MATERIALS AND METHODS. Ninety-four patients with nonsuspicious findings on digital rectal examination and a mean prostate-specific antigen level of 16.3 ± 10 ng/mL (median, 13 ng/mL) underwent endorectal sonography, color Doppler sonography, sextant endorectal sonographically guided biopsy, and endorectal MR imaging before radical prostatectomy.RESULTS. Tumors were visible in 48 cases and not visible in 46. The mean Gleason biopsy score, the frequency of tumors involving three sextants or more of the prostate gland at biopsies, and the frequency of stage pT3 tumors were significantly higher in patients with visible tumors (5.9 ± 0.9, 42%, and 37.5%) than in those with invisible tumors (5.4 ± 1.1, 17%, and 17%). The 42 hypervascular tumors were hypoechoic in every ca...