TRUS and Biopsy: Practical Aspects

Transrectal ultrasonography (TRUS) has become a standard imaging technique for prostatic diseases and ultrasound guided biopsies are the golden standard for the early detection of prostate cancer. Newly developed TRUS modalities, such as computer assisted automated detection, neural networks, colour Doppler ultrasound (CDU), power Doppler ultrasound (PDU), contrast ultrasound and three-dimensional imaging cannot replace systemic biopsies in the diagnosis of prostate cancer. However, such modalities will be able to improve biopsy yield and increase sensitivity and specificity of traditional grayscale TRUS. Their use in non-surgical treatment of localised prostate cancer may also improve outcome and reduce side-effects, such as erectile dysfunction. Nevertheless, because the improvements made so far are limited and the fact that these modalities are expensive, they do not yet have a place in routine practice.