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October 21, 1988

Transrectal Ultrasonography: Is It Ready for Routine Use?-Reply

Author Affiliations

University of Chicago

University of Chicago

JAMA. 1988;260(15):2215-2216. doi:10.1001/jama.1988.03410150063018

In Reply.—  In the recent editorial on transrectal ultrasonography, the efficacy of ultrasonically guided radioactive seed implants was judged to be investigational because the use of surgically placed125I seeds has not been as effective as external beam radiation in controlling this disease.1 Nevertheless, Dr Baumgartner cites a recent study2 in which the rate of positive prostate biopsy findings following interstitial radiation therapy was similar to the rate observed following external beam radiation therapy. Based on these data, he apparently concludes that interstitial radiation is as effective as external beam radiation.There are two problems with the study cited. First, there may have been a substantial selection bias, because 60% of the patients did not undergo a prostate biopsy following treatment. Second, although the number of cases in each group was small, the rates of positive prostate biopsy findings were higher for patients with moderate and poorly