Introduction: The introduction of transrectal ultrasound (TRUS) of the prostate to the United States in the early 1970s revolutionized the field of urology. In 1964 Japanese researchers obtained the first crude TRUS images of the prostate. Next, in 1967, Japanese urologist Watanabe produced the first clinically useful TRUS images. In the early 1970s, William H. Boyce led studies on TRUS for prostate imaging in the USA. In 1997, David L. McCullough extended this imaging innovation to a game-changing advance in patient care, described in a landmark clinical trial of systematic TRUS prostate biopsy. We present the contributions of these two pioneers as important contributors to the transformation of urology to focus on the early detection of prostate cancer. Methods: The authors reviewed primary and secondary sources including research contributions by Boyce and McCullough on the topics of TRUS and prostate biopsy. Web searches of available works were performed with Google Scholar and PubMed and internal searches of our institution’s libraries. Results: We identified eight primary sources that met inclusion criteria. Boyce’s contributions to TRUS of the prostate were first noted in a 1972 presentation to the American Institute of Ultrasound in Medicine. In 1973, he described a 3.5 MHz rectal transducer to evaluate prostate size and pathology. In this study, the authors performed “Prostatic Echography” on 66 patients and contributed early descriptions of benign prostatic hypertrophy and malignancy. He expanded on echography’s potential to increase detection of early malignancy and guide decision making through accurate staging. Boyce’s TRUS laid the foundation for McCollough to publish the “five region” biopsy for elevated PSA, shifting the paradigm from the previous standard sextant biopsy to the modern 12 core biopsy. Conclusions: William H. Boyce and David L. McCullough were initial contributors to early detection of prostate cancer. Boyce’s work was seminal to the development of TRUS as a gold standard diagnostic tool. McCollough used his knowledge of prostate ultrasonic anatomy to establish a standardized biopsy approach that to this day directs imaged-guided biopsy techniques. While MRI fusion is becoming the modern standard, the concept of selective/systematic biopsies started with Boyce and McCullough. SOURCE OF Funding: None
