The role of colour Doppler ultrasonography in detecting prostate cancer

Objective To determine the usefulness of colour Doppler ultrasonography (CD US) in detecting prostate cancer, by comparing CDUS with grey-scale transre ctal ultrasonography (TRUS) and magnetic resonance imaging (MRI). Patients and methods In all, 278 patients who underwent prostate biopsies b ecause of an abnormal digital rectal examination, elevated prostate specifi c antigen levels, and/or abnormal TRUS between May 1998 and November 1999 w ere evaluated. The diagnostic accuracies of TRUS, CDUS, MRI and combination s of these imaging techniques in detecting prostate cancer were compared, b ased on the biopsy results. Results Carcinoma was detected in 233 of 1696 specimens, and 87 patients we re diagnosed with prostate cancer. For each detected cancer site, the sensi tivity of CDUS was lower than those of other imaging techniques, but CDUS h ad high a specificity and positive predictive value, The combination of gre y-scale TRUS and CDUS or MRI improved the sensitivity and negative predicti ve value. The specificity and positive predictive value of the combination of grey-scale TRUS and MRI were less than those for grey-scale TRUS alone, while those for the combination of grey-scale TRUS and CDUS were higher tha n those for grey-scale TRUS alone. Five tumours were isoechoic but seen as hypervascular lesions with CDUS. Conclusion CDUS provides information useful for detecting prostate cancer w hen used in combination with grey-scale TRUS, and should be included in the routine examination for prostate cancer.