Correlation between Ultrasound Features and Histopathological Findings in Prostate Cancer at Tertiary Care Hospital

Open Access

Abstract

Background: Prostate cancer is one of the most commonly diagnosed malignancies in men worldwide and a major cause of morbidity and mortality. Despite the widespread use of imaging modalities like transrectal ultrasound, histopathological confirmation remains the gold standard, and local data correlating ultrasound features with tumor pathology are limited. Objective: The aim of the study was to evaluate the correlation between ultrasound features and histopathological findings in patients with prostate cancer at a tertiary care hospital. Methods & Materials: This cross-sectional observational study was conducted at the Department of Radiology and Imaging, Bangladesh Medical University, and the National Institute of Kidney Diseases and Urology, Dhaka, Bangladesh, from January to June 2021, including 200 male patients aged ≥50 years with indications for prostate biopsy. TRUS was performed to assess hypoechoic lesions, irregular margins, increased vascularity, and calcifications, followed by histopathology and Gleason scoring. Associations between ultrasound features and histopathology, diagnostic performance, and Gleason scores were analyzed using chi-square tests (p < 0.05). Results: In 200 patients (mean age 65.1 ± 7.5 years), hypoechoic lesions (72.5%), irregular margins (55.0%), and increased vascularity (47.5%) were common. Prostate adenocarcinoma was diagnosed in 160 cases (80.0%), mostly intermediate grade (43.8%). Ultrasound features were significantly associated with malignancy and Gleason score, with hypoechoic lesions showing highest sensitivity (81.3%) and PPV (89.7%) and increased vascularity highest specificity (75.0%). Conclusion: Transrectal ultrasound features, particularly hypoechoic lesions, irregular margins, and increased vascularity, reliably correlate with histopathology and tumor grade, making them valuable for detecting and assessing prostate cancer.