Suprapubic sonographic detection of prostate carcinoma.

Between January 1 and March 31, 1983, 103 patients scheduled for prostatic surgery were blindly evaluated preoperatively by suprapubic real time sonography. Prospectively, the sensitivity was 72.7%, specificity 72.2%, predictive value of positive test 51.6% and predictive value of negative 86.7% for the detection of prostatic carcinoma. Retrospective analysis increased the sensitivity to 86% and when clinical information was utilized, only one carcinoma escaped detection. Unfortunately, both prostatic inflammation and occasionally benign prostatic hypertrophy may simulate carcinoma sonographically, thus producing a significant number of false positives. No ultrasonically detectable characteristics could be found which unequivocally separate carcinomas from inflammation and hypertrophy. For this reason routine suprapubic screening does not seem warranted.