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Prostate cancer: diagnosis with color Doppler sonography with histologic correlation of each biopsy site
J S Newman1, R L Bree, J M Rubin
1Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109-0326.
Purpose:
To correlate the findings at prostate color Doppler sonography (CDS) with those of site-specific transrectal core biopsy.
Materials And Methods:
Forty-three patients underwent prostate transrectal ultrasonography (US) and biopsy. CDS was performed at all biopsy sites before US-guided core biopsy. Vascularity at CDS was prospectively graded on a scale of 0-2 (0 = no visible peripheral zone [PZ] flow, 2 = markedly increased PZ vascularity). CDS results were correlated with histologic findings from 220 separate biopsy sites that included 27 focal lesions.
Results:
Of 34 grade 2 biopsy sites, 21 revealed carcinoma, eight revealed prostatitis, and five were negative. CDS depicted at least one focus of carcinoma in seven patients with no gray-scale abnormality. CDS had a sensitivity of 49%, specificity of 93%, and positive predictive value of 62%.
Conclusion:
Focal PZ hypervascularity at CDS is associated with an increased likelihood of prostate cancer or inflammation at biopsy, often without a focal gray-scale abnormality. CDS may help identify an appropriate site for biopsy. A negative CDS scan, however, should not preclude biopsy, as CDS has a limited sensitivity in the detection of all sites of cancer.