The Role of Power Doppler Ultrasonography in the Diagnosis of Prostate Cancer: a Preliminary Study

Abstract

Objective. To determine the role of transrectal power Doppler ultrasonography (PDU) in the diagnosis of prostate cancer. Patients and methods. Thirty-six patients (mean age 66.4 years, SD 7.7, range 59-82) with possible prostate cancer, suspected from an abnormal digital rectal examination or elevated prostate specific antigen level, underwent transrectal ultrasonography, transrectal PDU and biopsy. The vascularity on PDU was graded on a scale of 0-2, where grade 1-2 was considered positive and grade 0 negative. Results. The vascularity was grade 2 in 11 patients, grade 1 in 11 and grade 0 in 14; 20 of the 36 (56%) patients had prostate cancer. Of the 22 patients positive on PDU, 18 had malignant disease and four benign; two of 20 patients with histopathologically confirmed malignancy had a normal PDU. The sensitivity of PDU was 90%, the specificity 75% and the positive predictive value 82%, Conclusion. Focal hypervascularity on PDU was associated with an increased likelihood of prostate cancer. Although ultrasonography alone cannot detect all cancers, even using PDU, the technique appears to increase the sensitivity and to help identify appropriate sites for biopsy.