The potential value of power Doppler ultrasound imaging compared with grey-scale ultrasound findings in the diagnosis of local recurrence after radical prostatectomy.
OBJECTIVE
To determine the value of power Doppler ultrasound (PDUS) imaging during transrectal ultrasonography (TRUS) in detecting local recurrence after radical retropubic prostatectomy (RRP).


METHODS
Eighteen patients were evaluated in whom local recurrence of prostate cancer was suspected on the basis of elevated serum prostate-specific antigen (PSA) levels (above 0.4 ng/ml) after RRP with no evidence of metastatic disease. Grey-scale TRUS and PDUS-guided biopsies of the vesicourethral anastomosis (VUA) and perianastomotic soft tissues were obtained after TRUS examinations of the prostatic fossa. The ability to detect locally recurrent prostate cancer using grey-scale TRUS alone was compared with TRUS combined with PDUS.


RESULTS
Fifteen of the 18 patients (83%) had positive biopsies for local recurrent tumour at histological examination. TRUS alone detected grey-scale abnormalities in 15 of 18 patients (83%), of whom 14 (77%) had positive TRUS-guided biopsies. PDUS during TRUS showed hypervascularity in 14 of 18 patients (77%). Biopsies of these hypervascular regions were positive in all patients (100%). The sensitivity and specificity of TRUS alone in detecting recurrent tumour were 93 and 67%, respectively, with a positive predictive value (PPV) of 93% and a negative predictive value (NPV) of 67%. TRUS combined with PDUS had a sensitivity and specificity of 93 and 100%, respectively, with a PPV and a NPV of 100 and 75%, respectively.
Tamsel
S
S
Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey.
Killi
R
R
Apaydin
E
E
Hekimgil
M
M
Demirpolat
G
G
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy / Q000379:methods; D004812:Epidemiologic Methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional / Q000379:methods
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen