Prospective evaluation of prostate with transrectal spectral Doppler with biopsy correlation - A clinico-pathologic study.

PURPOSE - To compare the trans-rectal (TR) spectral Doppler findings between benign prostatic hyperplasia (BPH) group and prostate cancer group.

MATERIALS AND METHODS - All the patients were assessed for adequate preparation and informed consent was obtained prior to the procedure.

The control group (n=33) comprised of patients who were negative for malignancy on biopsy. Study group (n=22) were positive for malignancy and were also divided into three groups on the basis of Gleason score. Study parameters included mean values for Resistive index (RI); Pulsatality index (PI) and Systolic/Diastolic ratio (S/D) and Peak systolic velocity (PSV). These were separately measured for bilateral capsular and urethral branches and compared between groups. In patients with unilateral tumor, these were compared between tumor and non-tumor side. Finally, the parameters were compared with patient's age. Mann-Whitney U test was used to evaluate the statistical significance.

RESULTS - The mean values of RI, PI, S/D and PSV were found to be 0. 84/1. 03;1. 8/1. 99; 3. 93/4. 45 and 15. 52/16. 15 cm/sec respectively in control and study groups which were not statistically significant. In patients with unilateral malignancy (n=16), there was no significant difference from non-tumor side. Doppler parameters showed statistically significant relation with age. Mean of minimum RI was found to be 0. 60 in patients < 60 years and 0. 76 in patients > or equal to 60 years of age in the benign category [p value 0. 014]. PI and S/D also showed significant difference in the benign category.

CONCLUSIONS - TR Spectral Doppler parameters did not reveal any significant difference in patients with or without prostatic malignancy, irrespective of Gleason grade. Doppler parameters however, showed significant correlation with age and were lower in younger patients. Advances in Knowledge: TR spectral Doppler is unlikely to emerge as diagnostic and prognostic tool for carcinoma prostate.

The British journal of radiology. 2016 Feb 10 [Epub ahead of print]

Syed M Danish Qaseem, Nitin P Ghonge, Bharat Aggarwal, Sanjeev Singhal

1 Vatika Medicare, H1A, Hauz Khas, New Delhi. , 2 Apollo Hospital, New Delhi. , 3 Max Hospital, New Delhi. , 4 Northern Railway Central Hospital, New Delhi.