Analysis of three-dimensional ultrasound Doppler for the detection of prostate cancer

Objectives. To investigate the relative effectiveness of Doppler ultrasound quantitative measures in discriminating prostate cancer from normal prosta te tissue. The true locations of prostate cancer within these prostates wer e determined by histologic examination after radical prostatectomy. Methods. Three-dimensional Doppler ultrasound data were acquired from 39 me n before radical prostatectomy. The removed prostates were sectioned and al l cancerous regions in each prostate were identified on whole-mount hematox ylin-eosin-stained slides. The ultrasound and histologic data were then spa tially registered. Biopsy results were simulated on a grid of potential sit es within each prostate. Along each simulated biopsy site, the amount of ca ncer was computed from the hematoxylin-eosin-identified cancerous regions a nd the peak speed-weighted pixel density (SWD) was compared. Results: By selecting the biopsy sites with higher associated SWDs within e ach sextant, the probability of having at least one positive biopsy within a prostate increased from 75% if the SWD was ignored to 85% if only the top 15% of potential biopsy sites in each sextant were selected. This trend wa s seen within each sextant individually as well. Conclusions. Doppler ultrasound provides discriminatory information for pro state cancer using the SWD. Translating this into a practical strategy that might improve the yield of prostate biopsy remains under development. The results of our study indicate that biopsying regions of high Doppler color could potentially increase the cancer yield to a small degree and improve t he accuracy of the biopsy results. These results also objectively verify pr evious visual studies suggesting a modest improvement with the use of color Doppler. UROLOGY 57: 1128-1132, 2001, (C) 2001, Elsevier Science Inc.