PROSTATE-CANCER - DIAGNOSIS WITH COLOR DOPPLER SONOGRAPHY WITH HISTOLOGIC CORRELATION OF EACH BIOPSY SITE

PURPOSE: To correlate the findings at prostate color Doppler sonograph y (CDS) with those of site-specific transrectal core biopsy. MATERIALS AND METHODS: Forty-three patients underwent prostate transrectal ultr asonography (US) and biopsy. CDS was performed at all biopsy sites bef ore US-guided core biopsy. Vascularity at CDS was prospectively graded on a scale of 0-2 (0 = no visible peripheral zone [PZ] flow, 2 = mark edly increased PZ vascularity). CDS results were correlated with histo logic findings from 220 separate biopsy sites that included 27 focal l esions. RESULTS: Of 34 grade 2 biopsy sites, 21 revealed carcinoma, ei ght revealed prostatitis, and five were negative. CDS depicted at leas t one focus of carcinoma in seven patients with no gray-scale abnormal ity. CDS had a sensitivity of 49%, specificity of 93%, and positive pr edictive value of 62%. CONCLUSION: Focal PZ hypervascularity at CDS is associated with an increased likelihood of prostate cancer or inflamm ation at biopsy, often without a focal gray-scale abnormality. CDS may help identify an appropriate site for biopsy. A negative CDS scan, ho wever, should not preclude biopsy, as CDS has a limited sensitivity in the detection of all sites of cancer.