Prostate cancer: diagnosis with color Doppler sonography with histologic correlation of each biopsy site.
OBJECTIVE
To correlate the findings at prostate color Doppler sonography (CDS) with those of site-specific transrectal core biopsy.


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%.


CONCLUSIONS
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.
Newman
J S
JS
Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109-0326.
Bree
R L
RL
Rubin
J M
JM
D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D011472:Prostatitis / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
D017430:Prostate-Specific Antigen