The association of TR systematic echobiopsy of the prostate with power Doppler (PDU) in borderline PSA patients.
OBJECTIVE
TR systematic biopsy of the prostate is currently a method to diagnose prostate cancer, though with limited reliability. Many ancillary procedures have been put forward to improve its effectiveness, and PDU appears a very promising one Wehave attempted to verify whether PDU and eighth core TR biopsy together can ihcrease reliability especially in those patients with PSA values between 4 and 10 ng/ml.


METHODS
Two groups of patients suffering from altered PSA and/or a palpable prostatic nodule underwent eighth core TR biopsy of the prostate. The first group was composed by 56 patients aged 55-82 (av.69.39) with PSA values ranging between 0.87 and 94.91 ng/ml (11.45 +/- 10.14) of which 29 had a palpable nodule. The second group was constituted by 96 patients aged 49-84 (av.69.84) with PSA values ranging between 1.14 and 59.7 ng/ml (12.8 +/- 11.66) of which 55 had a palpable nodule. The first group underwent eighth core TR biopsy, the second group TR biopsy and PDU.


RESULTS
Twenty-five patients of the first group (44.64%) showed prostate cancer and 48 of the second (50%) were prostate cancer positive. We then divided them according to their PSA: 33 belonging to the first group (biopsy without PDU) had PSA values ranging between 4 and 9.6 ng/ml (7.59 +/- 1.61) and 13 (39.39%) were positive to Ca; 56 patients belonging to the second group (biopsy with PDU) had PSA values ranging between 4.09 and 9.66 ng/ml (7.02 +/- 1.56) and 26 (46.42%) were positive to Ca. We also ran tests with other groups of patients according to their PSA values although the above findings remained the most significant.


CONCLUSIONS
Compared to other similarly interesting but more complex procedures, PD is easy to learn and easy to perform. Literature already shows how it can effectively be associated with systematic TR biopsy. On the basis of the above data we can conclude that PDU realistically improves reliability of eighth core TR biopsy--though not replace it--especially for those patients with PSA values between 4 and 10 ng/ml.
Passavanti
Giandomenico
G
UO Urologia Ospedale Misericordia, Grosseto, Italy. mpeppina@infinito.it
Pizzuti
Valerio
V
Bragaglia
Alessandro
A
Costantini
Fabio Massimo
FM
Paolini
Riccardo
R
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology*; D018608:Ultrasonography, Doppler
D017430:Prostate-Specific Antigen