PROSTATIC-CANCER - ROLE OF COLOR DOPPLER IMAGING IN TRANSRECTAL SONOGRAPHY

OBJECTIVE. The aim of this study was to assess the roles of transrecta l color Doppler and gray-scale sonography in revealing prostatic cance r, using biopsy as the reference standard. SUBJECTS AND METHODS, Two h undred fifty-six patients referred for urologic studies underwent tran srectal sonography using gray-scale and color Doppler scanning. All ab normal areas shown on gray-scale or color Doppler sonography or both w ere targeted and biopsies were performed. The patients also underwent random sextant biopsies. All biopsies were individually correlated wit h histopathologic findings and all results were analyzed. RESULTS, Can cer was found on biopsy in 100 patients (39%), and equivocal sonograph ic results or prostatic intraepithelial neoplasia was found in 22 othe r patients (9%). In 16 of the patients in whom cancer was detected, th e tumors were correctly revealed only with color Doppler sonography. T hese 16 patients had a mean Gleason score of 6.4 (range, 5-8). Biopsy findings in these 16 patients showed eight patients with extensive les ions, three with moderate lesions, and five with minimal lesions. Howe ver, in nine other patients with cancer (9% of cancers detected), both gray-scale and color Doppler sonography failed to reveal lesions that were found on sextant biopsy. An analysis showed that, although highl y sensitive, color Doppler sonography was somewhat less specific than gray-scale sonography. CONCLUSION. Color Doppler sonography should bec ome a routine part of transrectal sonography of the prostate gland to improve detection and targeting of lesions. The practice of performing random sextant biopsies should also continue.