Correlation between Doppler vascular density and PSA response to radiation therapy in patients with localized prostate carcinoma.
OBJECTIVE
The authors performed this study to ascertain whether there is a correlation between pretreatment Doppler vascular density (DVD) of the prostate and prostate-specific antigen (PSA) response following radiation therapy in prostate cancer patients.


METHODS
Prior to radiation therapy, 14 patients with biopsy-proven carcinoma (of Gleason grades 2-7) were imaged with transrectal ultrasound in gray-scale, color Doppler, and power Doppler modes. The Doppler images were analyzed for mean DVD with the aid of a computer program. PSA levels were measured before therapy and every 3 months after therapy. The PSA measurements were fitted to an exponential to determine PSA halving time (T1/2). Correlations were made between T1/2 and the following pretherapy measurements: mean DVD, PSA level, prostate volume, and Gleason grade.


RESULTS
Median follow-up time was 392 days. A linear correlation with regression coefficient (R) of 0.75-0.80 was observed between mean DVD and T1/2 for color Doppler and power Doppler imaging. In both imaging modes, each percentage increase in mean DVD led to an increase in T1/2 by 25 days. Pretherapy prostate volume, PSA level, and Gleason score did not correlate with T1/2.


CONCLUSIONS
The pretreatment mean DVD correlates inversely with the rate of posttherapy decline in PSA in patients with prostate cancer. That is, pretreatment vascularity prognosticates postirradiation PSA response. The mechanism underlying this correlative relationship is not known.
Sehgal
Chandra M
CM
Department of Radiology University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA.
Arger
Peter H
PH
Holzer
Anson C
AC
Krisch
Robert E
RE
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply* / Q000000981:diagnostic imaging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D011882:Radiotherapy, High-Energy; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color
D017430:Prostate-Specific Antigen