Can color doppler predict the uniformity of HIFU-induced prostate tissue destruction?
BACKGROUND
Tissue blood perfusion influences the results of some hyperthermia and thermotherapy procedures, but its role in the outcome of prostate cancer treatment by high-intensity focused ultrasound (HIFU) has not been evaluated yet. We evaluated preoperative prostate color Doppler as a predictor of the efficacy of HIFU treatment.


METHODS
Thirty-five patients underwent pre- and post-contrast color Doppler examination of the prostate before HIFU treatment. Specific software was used to calculate, on color Doppler images, the color pixel density (CPD), and the specific flow (SF, i.e., mean velocity x CPD) in different regions of interest. Post-treatment sextant biopsies were obtained in 31 patients, 5.8 +/- 2.8 months after HIFU treatment.


RESULTS
No significant correlation was found between the uniformity of HIFU-induced tissue destruction observed on control biopsies and the pre-treatment CPD/SF values in any region of interest, either before or after contrast injection. On the other hand, history of radiation therapy was significantly associated with homogeneous tissue destruction and history of hormone therapy was significantly associated with incomplete tissue destruction.


CONCLUSIONS
Color Doppler cannot predict the uniformity of HIFU-induced tissue destruction. History of radiation therapy was found to be a factor of favorable prognosis and history of hormone therapy was found to be a factor of poor prognosis in our population.
Rouvière
Olivier
O
Department of Genitourinary Radiology, Hôpital E. Herriot, Lyon, France. oliver.rouviere@netcourrier.com
Curiel
Laura
L
Chapelon
Jean-Yves
JY
Bouvier
Raymonde
R
Ecochard
René
R
Gelet
Albert
A
Lyonnet
Denis
D
D000368:Aged; D001706:Biopsy; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy*; D012039:Regional Blood Flow; D012984:Software; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D018615:Ultrasonography, Doppler, Color