Power Doppler Ultrasonografy (Pdu) as an Additional Tool to Increase Reliability of Systematic Biopsy of the Prostate

Abstract

Diagnosis of prostate cancer has until recently relied primarily on eight core TR biopsy. Tests are being carried out to verify whether PDU can effectively aid such diagnosis thereby reducing the number of biopsies and tissue samplings. This has also been our attempt. Two groups of patients were examined for increased PSA with or without a palpable prostatic nodule. The first group was composed by 52 patients between 55 and 83 years of age (av. 69.57) with PSA values between 0.87 and 94.91 ng/mL (r.8.085) of which 29 (55.75%) showed a palpable nodule. All patients underwent prostatic eight core TR ecobiopsy. The second group was composed by 56 patients between 49 and 84 years of age (av.69.19) with PSA values between 1.14 and 59.7ng/mL (r.8.74) of which 33 (58.97%) showed a palpable nodule. This group of patients underwent a PDU just before TR biopsy in order to assess prostatic blood supply and locate possible alterations. Prostatic volume in both groups was never higher than 50 cc. Of the first group 25 patients (48.08%) were prostate cancer positive. Of the second group 31 patients (55.36%) were positive to a biopsy for prostate cancer. In addition 22 out of the 31 showed a vascular irregularity. From the evidence above (tests carried out by the same operator with two homogeneous groups of patients-Wilcoxon test-) it is clear that PDU usefully worked in diagnosing a higher number of prostate cancers. Diagnostic sensitivity and specificity was markedly increased by the association of PDU and TR biopsy.