[The role of power Doppler-guided prostatic biopsy in the diagnosis of prostate cancer].
Between March 1997 and December 1998, a total of 170 cases with an abnormal serum prostate specific antigen (PSA) level (range: 4.1-200, mean: 20.5 +/- 31.0) were chosen for this study. Following the evaluation of the prostate using power Doppler imaging (PDI) with a 7.5 MHz transrectal probe, the hypervascular lesion (HVL) was biopsied transperineally under PDI real-time guidance. Thereafter, when gray-scale transrectal sonography revealed a hypoechoic lesion, additional samples were taken from them. Finally, sextant systematic biopsy was performed in all cases. Prostatic biopsy was positive for cancer in 41 cases (24%). The positive biopsy rate was 59% (40/68) in cases with HVL, compared to 1% (1/102) in cases with no HVL (p < 0.0001). In 107 patients with serum PSA 4.1 to 10.0 ng/ml, biopsy was positive in 13 cases (12%). The positive biopsy rate was 38% (12/32) in cases with HVL, compared to 1% (1/75) in cases with no HVL (p < 0.0001). These results imply that HVL represents the neovascularity or increased perfusion of blood in the cancer lesion. Power Doppler-guided prostatic biopsy could be promising as a new biopsy technique in patients with abnormal PSA levels including moderately elevated PSA levels (4.1-10.0 ng/ml).
Okihara
K
K
Department of Urology, Kyoto Prefectural University of Medicine.
Kojima
M
M
Nakanouchi
T
T
Okada
K
K
Miki
T
T
D000368:Aged; D001706:Biopsy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018608:Ultrasonography, Doppler
D017430:Prostate-Specific Antigen