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Power Doppler Ultrasonography of the Feeding Arteries of the Prostate Gland

A Novel Approach to the Diagnosis of Prostate Cancer?

Ahmet Tuncay Turgut, MD, Esin Ölçücüolu, MD, Pinar Koar, MD, Pinar Özdemir Geyik, PhD, Uur Koar, MD and Vikram Dogra, MD

Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey (A.T.T., E.Ö., P.K., U.K.); Department of Biostatistics, Hacettepe University, Faculty of Medicine, Ankara, Turkey (P.Ö.G.); and Department of Imaging Sciences, University of Rochester School of Medicine, Rochester, New York USA (V.D.).

Address correspondence to Ahmet Tuncay Turgut, MD, 25. Cadde, 362. Sokak, Hüner Sitesi 18/30, Karakusunlar, 06530 Ankara, Turkey. E-mail: ahmettuncayturgut{at}yahoo.com

Objective. The purpose of this study was to assess the role of spectral Doppler ultrasonographic parameters of the feeding arteries of the prostate for the detection of prostate cancer. Methods. A total of 55 patients referred for prostate biopsy with a mean age of 66.4 years (range, 46–82 years) were included. In each patient, Doppler indices from bilateral capsular and urethral arteries were obtained. The indices were compared with regard to malignant (group A) and benign (group B) subgroups of histopathologic outcomes of transrectal ultrasonographically guided prostate biopsy for each side (n = 19 and n = 91 for groups A and B, respectively) and to assess whether the indices were significantly altered on the side with cancer compared with the contralateral side. Results. The mean pulsatility index value for the capsular artery of group A (1.49 ± 0.57) was significantly lower than that of group B (1.71 ± 0.52; P = .048). The mean resistive index and systolic/diastolic ratio for the capsular artery of group A (0.78 ± 0.10 and 5.40 ± 2.74, respectively) were lower than those of group B (0.82 ± 0.08 and 7.40 ± 4.91) despite being statistically insignificant (P = .075 and .119, respectively). Conclusions. Spectral waveform measurements by power Doppler transrectal ultrasonography may be useful in differentiating prostate cancer from benign hypertrophy. Further research is needed to elucidate the potential of spectral Doppler indices of the capsular and urethral arteries.

Key Words: prostate • prostatic neoplasms • transrectal color Doppler ultrasonography

Abbreviations: BPH, benign prostatic hyperplasia • CDUS, color Doppler ultrasonography • HGPIN, high-grade prostatic intraepithelial neoplasia • PCa, prostate cancer • PDUS, power Doppler ultrasonography • PI, pulsatility index • PSA, prostate-specific antigen • RI, resistive index • S/D, systolic/diastolic • TRUS, transrectal ultrasonography