title: Evaluation of color Doppler in guiding prostate biopsy after HIFU ablation.
abstract: OBJECTIVE
  Transrectal ultrasound cannot accurately depict early cancer recurrences after prostate high-intensity focused ultrasound (HIFU) ablation. We evaluated transrectal color Doppler (CD) in guiding post-HIFU prostate biopsy.
  
  
  METHODS
  Prostate CD-guided sextant biopsies were obtained in 82 patients who had undergone prostate HIFU ablation for cancer, 24 of whom had hormone therapy before the treatment. At the time of biopsy, a subjective CD score was given to all biopsy sites (0=no flow; 1=minimal flow; 2=suspicious flow pattern). CD findings were compared with biopsy results.
  
  
  RESULTS
  CD was a significant predictor of biopsy findings, according to univariate and multivariate site-by-site analysis. However, only 36 of 94 sites with residual cancer had positive CD findings, and thus, negative CD findings should not preclude random biopsy. There was a significant interaction between CD diagnostic capability and a history of hormone therapy before HIFU treatment. CD was a significant and independent predictor of biopsy findings in patients who had not received hormone therapy (odds ratio: 4.4; 95%CI: 2.5-7.9; p<0.0001), but not in those who had (odds ratio: 1.3; 95%CI: 0.5-3.4; p>0.5).
  
  
  CONCLUSIONS
  Biopsy taken in CD-positive sites were 4.4 times more likely to contain cancer in patients who did not receive hormone therapy. CD could not reliably depict cancer recurrence in patients with history of hormone therapy.
authors.affiliation: Department of Genitourinary Radiology, Pavillon P Radio, Hôpital E. Herriot, 5 place d'Arsonval, 69437 Lyon Cedex 03, France. olivier.rouviere@netcourrier.com
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouvière
authors.forename: Florence
authors.initials: F
authors.lastname: Mège-Lechevallier
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Chapelon
authors.forename: Albert
authors.initials: A
authors.lastname: Gelet
authors.forename: Raymonde
authors.initials: R
authors.lastname: Bouvier
authors.forename: Florent
authors.initials: F
authors.lastname: Boutitie
authors.forename: Denis
authors.initials: D
authors.lastname: Lyonnet
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods*; D002277:Carcinoma / Q000601:surgery / Q000628:therapy; D004724:Endoscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000601:surgery; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000601:surgery / Q000628:therapy; D013223:Statistics as Topic; D014464:Ultrasonic Therapy / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000379:methods