Radiology, Vol 195, 86-90, Copyright © 1995 by Radiological Society of North America
Prostate cancer: diagnosis with color Doppler sonography with histologic correlation of each biopsy site
JS Newman, RL Bree and JM Rubin
Department 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.
