Diagnosis of Carcinoma Prostate Based on Transrectal Ultrasound Doppler Findings Validated Against Transrectal Ultrasound Guided Biopsy
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 3
Abstract
Background: Prostate cancer is the fifth leading cause of death from cancer in men, accounting for about 6.6% of the total deaths in men. Mortality rates are generally high in predominantly black populations and very low in Asia[1]. However, according to recent studies based on National Cancer Registry, the incidence of carcinoma prostate is on the rise in India[2] . The study aims at validitating Transrectal ultrasound Doppler findings in patients clinically diagnosed to have prostatic malignancy, using Transrectal ultrasound guided biopsy findings as reference standard. Materials and Methods: Diagnostic test evaluation was done by validating Transrectal ultrasound Doppler findings with histopathology, which is taken as reference standard. All patients between the age of 40 –75 years clinically suspected to have carcinoma prostate by the urologist, referred to Department of Radiodiagnosis, were taken as study subjects. Transrectal ultrasound (TRUS) guided 12 core sextant biopsy was performed in all 166 of the study subjects with additional cores from suspicious lesions identified by Doppler pattern criteria defined in the study. Malignant lesions were graded by Gleason scoring after histopathological evaluation. Results: The lesion characterisation by the defined Doppler criteria, was found to have a high sensitivity of 74.68% and a positive predictive value of 73.75% while retaining an equally high specificity of 75.86% and a negative predictive value of 76.34% . Doppler was found to be particularly useful for evaluation of isoechoic lesions which were missed by gray scale. Conclusion: From this study, TRUS Doppler patterns for lesions likely to be malignant were identified. Thus TRUS guided targeted biopsies of suspicious lesions may be recommended in selected patients (elderly, patients with comorbidities), in whom, invasive multicore sextant biopsies may be avoided
Authors and Affiliations
Dr Josey Verghese
Keywords
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