title: Transrectal doppler ultrasound during prostate biopsy: clinical utility and limitations.
abstract: OBJECTIVE
  To determine the clinical utility and limitations of guided prostate biopsy Power Doppler in patients with elevated serum PSA levels.
  
  
  METHODS
  Prospective study. From April 2012 to May 2013, 111 men over 45 years of age with serum PSA level greater than 4.0ng/dl who underwent a transrectal prostate biopsy were included. The hypoechoic nodules in the peripheral region were considered positive on the gray scale. Subsequently, the study was conducted with the Power Doppler, where the vascularization of suspicious images was analyzed for sampling. In addition, samples were taken from the suspected areas when performing the digital rectal examination. We calculated sensitivity, specificity, positive predictive value and negative predictive value of the three tests (digital rectal examination, standard gray scale ultrasound and power Doppler).
  
  
  RESULTS
  Prostate cancer was diagnosed in 48 of the 111 patients (43%). Fifty-nine cases (53%) were defined as positive with the Power Doppler. Of these, 39 (66%) corresponded to a diagnosis of prostate adenocarcinoma. The Power Doppler was positive in 39 cases of the 48 patients diagnosed with cancer and the gray scale ultrasound was positive in 31 cases. Overall sensitivity of the power Doppler was 81%, specificity 68%, PPV 66% and NPV 82%, which was higher compared to the other methods (P<.05).
  
  
  CONCLUSIONS
  Currently, prostate biopsy using Power Doppler does not seem to identify prostate cancer with sufficient accuracy to omit the guided systematic biopsy gray scale, the combined use of these methods being preferable.
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina. Electronic address: anjoez@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Ezquer
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: M C
authors.initials: MC
authors.lastname: Ortega Hrescak
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Sanagua
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: P
authors.initials: P
authors.lastname: Roggia-Rebullida
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: R
authors.initials: R
authors.lastname: López
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Cenice
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: F H
authors.initials: FH
authors.lastname: Veglia
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Veglia
authors.affiliation: Instituto Urológico Privado Prof. Dr. Ronald Parada Parejas, San Miguel de Tucumán, Tucumán, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Fernández
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012007:Rectum; D018615:Ultrasonography, Doppler, Color / Q000379:methods
keywords: Doppler; Ecografía transrectal; Neoplasias de próstata; Prostate neoplasms; Transrectal ultrasound