ABSTRACT
Purpose: To evaluate power Doppler imaging techniques as new ultrasound technologies in prostate cancer detection and as a complementary part of TRUS assessment of the prostate
Material and Methods: 101 patients, suspected to have prostate cancer, were chosen from those attending the out-patient clinics of Urology Department in Benha Faculty of Medicine. Their ages ranged from 53 to 87 years. All patients were complaining of LUTS, they were subjected to thorough clinical examination, DRE, PSA measurement TRUS and PDI. Moreover, TRUS-guided biopsies from the prostates were done for all patients to confirm the diagnosis
Results: Forty patients [39.6%] were proved to have prostate cancer by TRUS-guided biopsy. DRE detected 27 prostate cancer patients [67.5%], while it was negative in 13 prostate cancer patients [32.5%]. PSA was high in 37 prostate cancer patients [92.5%], while it was normal in 3 prostate cancer patients [7.5%]. Positive TRUS findings were detected in 35 prostate cancer patients [87.5%], while 5 cancer patients [12.5%] were negative by TRUS. PDI was positive in 24 prostate cancer patients [60.0%], while it was negative in 16 [40.0%]. In addition, the results of PDI were studied in view of those of DRE, PSA and TRUS. PDI detected 17 [63.0%] prostate cancer patients out of 27 DREpositive cancer patients. Seven prostate cancers [53.8%] DRE-negative prostate cancer patients were detected by PDI. PDI detected 23 [62.2%] prostate cancer patients out of 37 cancer patients with elevated PSA levels and one [33.3%] prostate cancer patient with normal PSA. Finally PDI was positive in 23 [65.7%] prostate cancer patients out of 35 patients who were TRUS-positive, and one [20.0%] of TRUS-normal cancer patients detected by PDI
Conclusion: Although having a limited accuracy, the diagnostic triad of DRE, PSA and TRUS remains the clue and first step in the diagnosis of prostate cancer. In this respect, PDI can draw attention to the presence of hypervascular suspected lesions; however, a confirmatory TRUS-guided biopsy will still be necessary as a gold standard test in the diagnosis of prostate cancer