CORRELATION OF COLOR DOPPLER FLOW IN THE PROSTATE WITH TISSUE MICROVASCULARITY

BACKGROUND. The pathophysiology of increased color Doppler (CD) flow h as not previously been addressed in histologic evaluations of microvas cular parameters. In this study, the authors attempted to define the d ifferences between benign and malignant biopsy cores found in regions of the prostate with normal and high CD flow. METHODS. Forty patients were retrospectively chosen for CD histologic comparison, each of whom had a core from a sextant biopsy with the following characteristics: malignant tissue with distinct increased CD flow (n = 11), malignant t issue with normal CD flow (n = 10), benign tissue with distinctly incr eased CD flow (n = 9), or benign tissue with normal CD flow (n = 10). AU biopsy cores were stained with factor VIII-related antigen to ident ify microvasculature and to determine the number of microvessels per s quare millimeter (mm(2)) in an average cross-sectional area of microve ssels, the percentage of tissue occupied by microvasculature, and the Gleason score. RESULTS. In biopsies of benign tissue, high CD flow was associated with greater numbers (P < 0.025) of vessels of similar siz e than in normal flow benign biopsies. Biopsies of malignant tissue co ntained significantly greater numbers (P < 0.01) of much smaller vesse ls (P < 0.0005) than biopsies of benign tissue. In biopsies of maligna nt tissue, no significant differences in microvasculature parameters w ere noted between high and normal CD flow, yet biopsies with high CD f low had average Gleason score of 6.7 compared with only 5.9 for biopsi es with normal CD flow (P < 0.025). CONCLUSIONS. Increased CD now in b iopsies of benign tissue was correlated with a greater number of vesse ls/mm(2), yet all biopsies of malignant tissue had more vessels/mm(2) than those of benign tissue. Increased CD flow in biopsies of malignan t tissue cannot be explained by standard microvasculature analysis but significantly guides biopsies to regions with a greater Gleason score . (C) 1998 American Cancer Society.