Computerized transrectal ultrasound of the prostate in a multicenter setup (C-TRUS-MS): detection of cancer after multiple negative systematic random and in primary biopsies

World J Urol. 2011 Oct;29(5):573-9. doi: 10.1007/s00345-011-0713-0. Epub 2011 Jun 21.


Objective: To improve prostate cancer diagnostic imaging, a computer-based analysis of the transrectal ultrasound signal (C-TRUS) was developed. Until recently, the C-TRUS existed only as a stand-alone device. Now, C-TRUS was developed into a network-compatible module (C-TRUS-MS). This new technology allows users to transmit C-TRUS images from any internet platform to C-TRUS-MS investigation. After analysis, the cancer-suspicious marked images are then retransmitted via internet. Targeted biopsies can then be taken at the urologists' office remotely.

Materials and methods: This prospective study investigates whether the rates of prostate cancer detection with C-TRUS-MS "multicenter online" are comparable with those achieved by the stand-alone unit. In addition to patients with a history of multiple systematic random biopsies, a group of patients who had not undergone systematic random biopsies were analyzed.

Results: A total of 1,545 digital images (2-23 per patient, median 6) from 57 urologists were transmitted to the analysis center. After analysis, the color-coded images were sent back electronically and utilized for a maximum of six targeted biopsies. C-TRUS-MS was able to detect prostate cancer in 91 patients. In addition, we evaluated 75 patients without any previous random biopsies. In this group, C-TRUS-MS was able to detect prostate cancer in 31 out of 75 patients (41%).

Conclusion: The results indicate that C-TRUS-MS "online" achieves similar results as the stand-alone system, independent of the user even with little experience in the method. Furthermore, C-TRUS-MS for the first time is able to detect carcinomas in patients without prior biopsies in a high number by taking only six targeted biopsies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods
  • Diagnosis, Computer-Assisted*
  • False Negative Reactions
  • Feasibility Studies
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostate / diagnostic imaging*
  • Prostate / pathology
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology
  • Ultrasonography