Transrectal ultrasound (TRUS) of the prostate provides high-resolution imaging of prostate gland anatomy, volume, and pathology. It is primarily used to guide prostate biopsies for cancer diagnosis and to measure prostate volume for BPH (benign prostatic hyperplasia) management and treatment planning.
Sonographers perform systematic prostate volume calculation using the prolate ellipsoid formula (length × width × height × 0.52), assess zonal anatomy (peripheral, central, and transition zones), and identify hypoechoic lesions or calcifications. During biopsy, the sonographer guides a spring-loaded biopsy needle to systematic and targeted sites using the biplane or end-fire probe. MRI-TRUS fusion biopsy integrates pre-acquired MRI targets with real-time ultrasound guidance to improve cancer detection rates.
TRUS falls under the ARDMS Abdomen (AB) or Small Parts (SP) specialty within the RDMS, though it may also be performed by urology technologists. Employment is in urology practices, hospital urology departments, and prostate cancer diagnostic centers. Proficiency in patient positioning, probe manipulation, and biopsy techniques is developed through dedicated hands-on training.