American Journal of Roentgenology, Vol 155, 811-815, Copyright © 1990 by American Roentgen Ray Society
Invasion of the seminal vesicles by prostatic cancer: detection with transrectal sonography
MK Terris, JE McNeal and TA Stamey
Division of Urology (S287), Stanford University Medical Center, CA 94305-5118.
Endorectal sonography provides a potential means of detecting seminal
vesicle invasion by prostatic cancer that is too subtle for diagnosis by
digital rectal examination. To assess this application of sonography, we
examined 300 patients with transrectal sonography of the prostate and
seminal vesicles followed by histologic examination of the seminal vesicles
from core biopsies and/or prostatectomy specimens. Of the 38 patients with
histologically proved seminal vesicle invasion by prostatic cancer, 35
(92%) had an abnormal appearance of the seminal vesicles on sonography. Of
167 patients with prostatic cancer without histologic evidence of seminal
vesicle involvement, sonograms showed abnormal seminal vesicles in 42
(25%). In 95 patients with histologically normal prostates and seminal
vesicles, sonograms showed abnormal seminal vesicles in 11 (12%). The
sonographic findings correlating best with tumor invasion of the seminal
vesicles were hyperechogenicity and a combination of two or more of the
following abnormalities: cystic dilatation, asymmetry, enlargement, and
anterior displacement. Our experience in these patients suggests that
endorectal sonography can be useful in the detection of seminal vesicle
involvement by prostatic cancer.
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