Transrectal Ultrasound

Aetna covers transrectal ultrasound (TRUS) for indications including assessment of anal sphincter dysfunction, clinical staging of prostate or rectal carcinoma, and determining prostate volume prior to brachytherapy (for prostate biopsy follow CPB 0698 – Prostate Saturation Biopsy). Excluded as experimental/investigational are biplane TRUS with ultrasonic elastosonography plus contrast-enhanced US for rectal cancer staging, high‑resolution microUS‑guided prostate biopsy, intraoperative MRI/US fusion optimization for low‑dose‑rate brachytherapy, photoacoustic imaging for prostate angiogenesis, and PET-directed 3‑D US‑guided prostate biopsy.

"Cost-effectiveness and long-term outcomes of mpMRI-based pathways depend on test costs and downstream management; findings are sensitive to these assumptions (economic studies cited)."

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