To cite this article: Merkle W. Successful Early Prostate Cancer Screening by Three-Dimensional Color Doppler Imaging-Transrectal Ultrasound: A Prospective Study.
UroToday Int J. 2009 Apr;2(2). doi:10.3834/uij.1944-5784.2009.04.08

Successful Early Prostate Cancer Screening by Three-Dimensional Color Doppler Imaging-Transrectal Ultrasound: A Prospective Study
ABSTRACT

INTRODUCTION: Prostate-specific antigen (PSA) screening has been used successfully for the early detection of prostate cancer, but it does not localize the cancer area inside the prostatic gland. Conventional transrectal ultrasound imaging can be used for positioning of the biopsy needle. However, proper targeting is almost impossible when cancers are small. Therefore, overlooked cancer or over-biopsy is a permanent risk. Biplane color Doppler imaging (CDI), a technique that is currently emerging due to improvements in cancer detection, cannot be used to differentiate between different types of hypervascularized lesions such as prostatitis or cancer. Three dimensional (3D) CDI transrectal ultrasound (TRUS) was developed to solve many of these problems.

METHODS: In a prospective and histologically verified study, 418 patients with slightly elevated range of PSA-levels and/or hereditary risk for prostate cancer were screened by 3D CDI-TRUS. Patients were then classified into benign or malignant according to ultrasound criteria and afterwards biopsied.

RESULTS: 3D CDI-TRUS was used to diagnose these patients correctly, with a sensitivity of 0.82 and good specificity (0.91).

CONCLUSION: 3D CDI-TRUS may be used for prostate cancer screening while reducing unnecessary biopsies in men with elevated PSA levels.

KEYWORDS: Prostate cancer screening; Prostate cancer detection; Transrectal ultrasound; Three dimensional transrectal ultrasound; Prostate biopsy.

Correspondence: Walter Merkle, M.D. Dept. of Urology, German Diagnostic Clinic, Aukammallee 33, Wiesbaden, Hessen, Germany 65191. Email: merkle.uro@dkd-wiesbaden.de

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