Transrectal Ultrasound for Prostate Cancer: Perspectives from National Cheng Kung University Hospital

Following a recent increase in the incidence and cancer deaths of prostate cancer, transrectal ultrasound (TRUS) has become an important tool that enables accurate sampling of prostate tissue for histologic examination in patients with a high risk of harboring cancer (patients with elevated prostate-specific antigen and abnormal digital rectal examination). The biopsy protocol continues to evolve with progress in ultrasound technology. In countries with a rising incidence of prostate cancer, it is important to determine an optimal biopsy strategy. In this article, we briefly summarize our experience and the problems we encountered when using TRUS in diagnosing prostate cancer at National Cheng Kung University Hospital. We also review progress in biopsy protocols according to the targeted lesion or systematic random biopsy protocols. We consider promising predictive models regarding the optimal number of biopsy cores and the probability of being diagnosed with prostate cancer. This information will enable biopsy strategies to be better applied according to the requirements of individual institutions.