Objectives: There is a need to improve pre-screening determination of prostate cancer in order to better select patients who need biopsy.
Such a strategy properly implemented, will decrease the number of negative biopsies for prostate cancer and in turn better balance the risks and morbidity for patients recommended for biopsy. The aim of study is to investigate Doppler spectral waveform parameters of NVB vessels and determine differences between benign and malignant pathologies.
Patients and Methods: We performed a prospective analysis involving 292 patients who received prostate biopsy for elevated PSA values or abnormal digital rectal examination, as well as 174 patients with symptomatic benign prostatic hyperplasia. DSW parameters (peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI)) were measured at bilateral NVB vessels via Doppler transrectal ultrasound at the right lateral decubitus position, compared and analyzed among patients with benign versus malignant histology for each side.
Results: Overall, both of PSV and EDV at malignant sides were significantly higher than those at benign sides, as well as lower RI (all p values < 0.05, unpaired t-test). In subgroup analysis with 93 patients of serum PSA between 10 and 20 ng/ml and 56 patients with one-side malignancy, higher EDV and lower RI were significantly associated with malignancies (all p, < 0.05). The values of PSV and EDV rather than RI might be influenced by the patients' position and RI by the prostate volume.
Conclusions: In this study, DSW parameters (mainly EDV and RI) at NVB vessels were significantly associated with prostate cancer, particularly in patients with serum PSA of 10-20 ng/ml. It should be in caution that the patients' position and prostate volume may influence the Doppler signal as demonstrated in the current study. These findings can provide more diagnostic information before prostate biopsy.
Written by:
Tsai YS, Jou YC, Chen CH, Chang CC, Yang WH, Lai J, Tzai TS. Are you the author?
National Cheng Kung University Hospital, Urology, #138, Sheng-Li Road, Tainan, Taiwan, 70401.
Reference: J Endourol. 2013 Oct 29. Epub ahead of print.
doi: 10.1089/end.2013.0383
PubMed Abstract
PMID: 24168710
UroToday.com Prostate Cancer Section
