Biologic aggressiveness of palpable and nonpalpable prostate cancer: assessment with endosonography

Article Abstract:

Endosonography (use of ultrasound waves to obtain images of internal tissues or organs) has been used as a diagnostic tool for the detection of prostate cancer. It is thought to be particularly useful for prostate cancer that is nonpalpable (not detectable by touch). In order for endosonography to be of use clinically, it must not only be able to detect prostate cancer, but it must also be able to increase life span while reducing the number of deaths, and be cost-effective. This study examined the relative severity of both palpable and nonpalpable prostate cancers to examine the usefulness of endosonography. The study also examined the costs of using endosonography in prostate cancer detection. Sonograms were obtained from 666 patients from a high-risk group (men over 50 years of age). These patients were also given physical examinations. Ninety-nine of the patients were found to have prostate cancer, 80 detected using both palpation and sonography, 9 using sonography alone, 8 using palpation alone, and 2 that were missed both by palpation and sonography. The cancers found were then rated for severity. The 11 nonpalpable cancers were found to be much less severe than the palpable cancers. The endosonography did help find these cancers, which palpation alone would not have done, but the type and severity of these cancers rendered their detection not very useful in a clinical sense. Also, the cost of using endosonography is also greater for detecting nonpalpable cancers because of a high-false positive rate (indicating tumors that are not in fact tumors). The results indicate that though endosonography detects nonpalpable prostate cancer, these are generally much less severe than palpable tumors and thus endosonography is clinically not very useful, since palpation alone is as effective and inexpensive. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Prostate cancer, Endoscopic ultrasonography

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Thyroid gland: US screening in a random adult population

Article Abstract:

The prevalence of thyroid diseases and abnormalities in the general population is difficult to measure. Clinical examination involves feeling the gland and is not very accurate. Autopsy studies are skewed because the age distribution of subjects rarely reflects that of the general population. Ultrasound (US) imaging, a noninvasive imaging technique that uses high frequency sound waves, can detect thyroid nodules and diffuse thyroid disease with high sensitivity. US was performed on a random sampling of adults to more accurately assess the prevalence of thyroid disease in the general population. A total of 252 adults aged 20 to 50 years were examined by US. Clinical thyroid examinations were also performed. Clinical examination results were thought to be indicative of thyroid disease in 13 of the 251 subjects (5.1 percent). US results for these 13 subjects showed thyroid nodules in 8 cases and no detectable abnormalities in 5 cases. Overall, US detected thyroid abnormalities in 69 subjects (27.3 percent). Biopsies of 30 patients did not reveal cancer. Most nodules seen on US were small in diameter. None of the subjects who underwent laboratory studies showed thyroid hormonal abnormalities. Women were more likely to have thyroid abnormalities on US examination than men, and the prevalence of abnormalities increased with age. The results indicate that thyroid abnormalities, as detected by US, are quite prevalent in the general population. Small thyroid nodules seen on US should be approached conservatively as they are unlikely to involve serious disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Abnormalities, Ultrasound imaging, Thyroid diseases, Thyroid gland

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