value of trnsrectal power doppler ultrasonography in cancer prostate

ABSTRACT

In attempt to assess the usefulness of transrectal power Doppler ultra-sonography [PDU] for improving the diagnoses of cancer prostate in-patients with abnormally elevated PSA, forty male patients with a mean age 65 years were assessed using a digital rectal examination [DRE], transrectal ultrasonography [TRUS] and [PDU]. All cases of prostatitis were excluded. The vascularity on PDU was graded on a scale of 0-3 where grade 0 negative and grade 1-3 was considered positive Transrectal needle prostatic biopsies were obtained from hypoechoic lesions or hyspervascular lesions under TRUS and PDU and systematic biopsy was taken in all cases. The results of PDU, DEE and TRUS were evaluated according to histopathological examination of needle biopsy. Prostatic biopsy confirmed prostate cancer in 11 patients out of 40 patients [27.5%], PDU was positive in 16 patients, of whom 10 had prostate cancer [62.5%], all those but one having prostate cancer were positive on PDU. Thus PDU had a higher sensitivity of 90.9% [10/11], than DRE [54.5%] and TRUS 72.7% and PDU had a higher negative predictive value in 95.8%, while 85% with TRUS and 80.7% for DRE. So, PDU increases the sensitivity and negative predictive value of TRUS in detection of cancer prostate if is it used as a routine investigation with conventional TRUS. This does not need any added manipulations. PDU is more useful for detecting prostate cancer in-patients with abnormally high serum PSA levels and if PDU is negative, needle biopsy may be avoided especially if PSA is not conclusively high