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Prostate cancer and the role of color Doppler US
I M Kelly1, W R Lees, D Rickards
1Department of Imaging, Middlesex Hospital, London, England.
Purpose:
To determine the role of color Doppler imaging (CDI) in diagnosis of prostate cancer.
Materials And Methods:
Transrectal ultrasound (TRUS) and CDI were performed in 456 patients with possible prostate cancer. Of these patients, 158 underwent prostate biopsy, and these formed the study group.
Results:
The frequency of malignancy was 47% (75 of 158). Of 136 TRUS-positive cases, 72 were malignant and 64 benign. Of 84 CDI-positive cases, 65 were malignant and 19 benign (chi 2 = 12.18, P < .001). Thirteen percent of histopathologically proved cases (10 of 75) were normal at CDI. TRUS alone had a sensitivity of 96% and a positive predictive value (PPV) of 0.53. The addition of CDI increased the PPV to 0.77 but reduced the sensitivity to 87%. In only one case out of 158 did CDI suggest the diagnosis of malignancy independently of TRUS.
Conclusion:
CDI improves the PPV of TRUS but appears to have little additional value over TRUS alone in diagnosis of prostate cancer.