Prospective evaluation of prostate with transrectal spectral Doppler with biopsy correlation: a clinicopathologic study

Abstract

Objectives: To compare the transrectal (TR) spectral Doppler findings between benign prostatic hyperplasia group and prostate cancer group. Methods: All the patients were assessed for adequate preparation, and informed consent was obtained prior to the procedure. The control group (n 5 33) comprised patients who were negative for malignancy on biopsy. The study group (n 5 22) were positive for malignancy and were also divided into three groups on the basis of the Gleason score. Study parameters included mean values for resistive index (RI), pulsatality index (PI), systolic/diastolic ratio (S/D) and peak systolic velocity (PSV). These were separately measured for bilateral capsular and urethral branches and compared between groups. In patients with unilateral tumour, these were compared between the tumour and non-tumour sides. Finally, the parameters were compared with patient's age. MannWhitney U test was used to evaluate the statistical significance. Results:The mean values of RI, PI, S/D and PSV were found to be 0.84/1.03, 1.8/1.99, 3.93/4.45 and 15.52/ 16.15 cm s 21, respectively, in the control and study groups which were not statistically significant. In patients with unilateral malignancy (n 5 16), there was no significant difference from the non-tumour side. Doppler parameters showed statistically significant relationships with age. The mean of minimum RI was found to be 0.60 in patients less than 60 years of age and 0.76 in patients more than or equal to 60 years of age in the benign category (p-value 5 0.014). The PI and S/D also showed significant difference in the benign category. Conclusion: TR spectral Doppler parameters did not reveal any significant difference in patients with or without prostatic malignancy, irrespective of the Gleason grade. Doppler parameters, however, showed significant correlation with age and were lower in younger patients. Advances in knowledge: TR spectral Doppler is unlikely to emerge as a diagnostic and prognostic tool for prostate carcinoma.

Prostate Cancer Vascularity: Superb Microvascular Imaging Ultrasonography with Histopathology Correlation

“…However, the sensitivity and specificity remain quite low due to the non-uniform characteristics of PCa on the conventional gray-scale ultrasound (US) images [3,4]. Previous studies applied color Doppler ultrasonography (CDUS) to improve the PCa detection rate [5,6], due to the association between angiogenesis and tumor growth [7]. CDUS measures the frequency shift in ultrasound waves as a function of blood velocity and direction, applying wall filtering to remove undesired slow blood flow signals that may be caused by slow, soft tissue motion [8].…”