Contribution of Color Doppler Sonography in the Diagnosis of Prostatic Pathologies.

Abstract

The aim of this study was to investigate the ability of color Doppler ultrasonography to determine prostate cancer, to evaluate the contribution of color Doppler ultrasonography to a conventional greyscale transrectal ultrasonography (TRUS) examination, and to assess the efficacy of prostate-specific antigen (PSA) values in the detection of prostate cancer in combination with sonographic imaging methods. Methods: A total of 78 patients who presented at the Radiology Department of Taksim Training and Research Hospital and were diagnosed with benign prostate hyperplasia or prostate cancer were included in the study. The age range of the patients was 49 to 90 years. A Diasonic VST Master color Doppler ultrasonography system with a 7-Mhz transrectal probe (Diasonic Technology Co. Ltd., Gyeonggi-do, South Korea) was used to assess the patients. The presence and number of nodules; the size, shape, and echo structure of the lesion; the loss of peripheral zone and inner gland border; capsular invasion; seminal vesicle thickening; and obliteration or patency of the prostate seminal vesicle angle as observed in the TRUS examination were noted. A vascularization map of different regions of the prostate gland was evaluated by section. The color flow was graded using a 3-point scale and the findings were compared with the pathology results. Results: Based on the results of a histopathological examination, 28 cases (36%) were malignant and the remaining 50 cases (64%) were benign. The mean PSA density (PSAD) value was 0.41 in the malignant cases and 0.23 in the benign cases. The best results for the diagnosis of prostate cancer were obtained with the combined use of TRUS, color Doppler ultrasound, and PSAD. The sensitivity, specificity, positive, and negative predictive value was 64%, 80%, 64%, and 80%, respectively. Conclusion: The addition of color Doppler ultrasound to TRUS increased the specificity and decreased the sensitivity (from 78% to 51%) of the findings. Though RDUS does not provide a significant advantage in the diagnosis of cancer, the color flow grading better determines the areas to be biopsied. Due to the poor sensitivity of a color Doppler examination, it should be evaluated with grayscale and PSA findings. The best specificity (80%) was observed with the combined use of these 3 methods.

Multiparametric ultrasound of prostate: role in prostate cancer diagnosis

“…This can be explained by the fact that prostatitis can be interpreted as a malignant lesion plus the preferential identification of larger and higher-grade lesions with Doppler, in which angiogenesis occurs more frequently. 37 , 38 Therefore, inflammatory changes or conditions within the prostate can be easily confused with a malignancy without the proper clinical correlation. CDUS can also be used in other situations such as surveillance comparisons on repeat biopsies or as a marker of not viable tissue after local treatments for PCa by measuring the absence of Doppler signals.…”