Download - TRUSP Report

Transrectal Ultrasound of the Prostate (TRUSP) Report

The transrectal ultrasound involves imaging of the prostate by means of a probe inserted into the rectum that allows visualization of the prostate using sound waves. This approach called TRUSP or TRUS is the method used by most urologists or radiologists to guide the biopsy needle in order to sample prostate tissue with the intent to diagnose PC.

Most urologists use the TRUSP solely for this purpose. However, the TRUSP can provide additional valuable information that includes but is not limited to:

• gland volume or GV
• areas of abnormal ultrasound pattern termed "hypoechoic" that are of lesser echogenicity and associated with a higher probability of PC involvement
• evidence of pathology involving the capsular e.g. capsular penetration
• evidence of PC involvement of the seminal vesicles
• PSA density or PSAD (PSA divided by gland volume)

Such information should be conveyed formally in a TRUSP report, an official document. Unfortunately, this is rarely found in the medical record. Instead, a "one-liner" hand-written note stating a TRUSP has been done is what we most commonly find. We should optimize the information conveyed from studies that relate to our lives and expect such information to be more formally presented. The TRUSP report form presented on the PCRI website is a first generation attempt to do this.

The gland volume is an important piece of information. It is used by most radiation oncologists to decide on the use of ADT(androgen deprivation therapy) to reduce the gland volume for the purpose of minimizing radiation to the bladder and/or rectum. GV's of greater than 40 cc are considered too high. Within 3-6 months of ADT, the gland volume can be reduced dramatically.

Secondly, the gland volume directly relates to the expression of benign-related PSA. The formula used is GV x 0.066 = the amount of PSA related to the contribution of benign prostate cells. If we subtract this amount from the total PSA we have the "excess" PSA. This is most likely related to the malignant prostate cells, the PC. If, in addition, we have obtained a Gleason score that has been validated by a PC pathology expert (http://www.prostate-cancer.org/tools/forms/pathology_biopsy_form.html), we can determine the PSA leak (the amount of PSA that is leaked into the bloodstream in relation to the Gleason score). If we divide the Excess PSA by the PSA leak, we have a calculated PC tumor volume. This is an approximation of the amount of PC present. All of this is shown in detail on the PCRI website at http://www.prostate-cancer.org/tools/software/tumorvol.html

Currently, the "sextant" biopsy approach is the most common strategy used is to target the prostate for the purpose of diagnosis of PC. This divides the prostate into six sectors. These include (from top to bottom) the base (right and left sides), the midgland (right and left sides) and the apex (right and left sides). The TRUSP form depicts this graphically. The sextant approach is being replaced with the 5-region biopsy or the 11 multi-site biopsy or other approaches that now incorporate significantly more sampling of the prostate. These approaches significantly increase the ability to diagnose prostate cancer earlier and avoid repetitive biopsy procedures that are stressful, uncomfortable and costly to the patient and the healthcare industry. The TRUSP report form on the PCRI website will be upgraded soon to reflect this improved biopsy strategy.

July 11, 2001

Click on the appropriate link below to download the form. All file download times are less than one minute with a 28.8K modem.

Download TRUSP Report.rtf - Right click the link and choose "Save Target As" or "Save Link As". File type is for Microsoft Word 2000/7.0/97 and other word processors.

Download TRUSP Report.zip - Contains the file in "zipped" format for easier downloading. File type is for Microsoft Word 2000/7.0/97 and other word processors.

Download TRUSP Report.pdf - Contains the file in Adobe Acrobat "PDF" format for universal viewing and printing.

Downloading Instructions:

Click on the appropriate link below to download the form. Most Report or Form download times are less than one minute with a 28.8K modem.

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