Abstract
Background: Prostate carcinoma is the fifth leading cause of death from cancer in men, accounting for about 6.6% of the total deaths in men Objectives: To evaluate the efficacy of transrectal ultrasonography in differentiating benign from malignant lesions and to assess the additional advantage of colour doppler when used in conjunction with grey scale ultrasonography.
Methodology: A prospective study was conducted in the Department of Radio diagnosis, Government Medical College, Kottayam for a period of 18 months from April 2016 to October 2017. Study population included 122 male patients with clinical symptoms or digital rectal examination suspicious of prostatic disease and / or patients with raised PSA [PSA>4ng/ml] The final imaging results were correlated with trus guided 12 core biopsy specimens or aspirated samples in cases where imaging findings were suggestive of abscess.
Results: Of the 122 cases studied, malignancy was found in 40.1% of cases and benign diseases were found in 59.9% of cases. The sensitivity, specificity, PPV and NPV in our study with transrectal ultrasound versus colour doppler are 75.51% vs 73.47%, 75.34% vs 80.82%, 67.27% vs 72% and 82.09% vs 81.94 %. Conjunction of colour doppler with grey scale ultrasound resulted in increase in sensitivity by 5% [81.63%], specificity by 3%.[78.08%],
Conclusion: Transrectal ultrasound grey scale with Colour doppler imaging findings alone are not sufficient for completely excluding malignancy. It can be used as an adjunct in evaluating suspicious lesions and as a screening modality to perform targeted biopsy in elderly debilitated males who cannot withstand a regular biopsy.
Keywords: Transrectal Ultrasound; Colour doppler; Resistive Index; Prostatic carcinoma.
References
- Elsevier Mosby; 2011. Krishnappa, Pravan Kumar Reddy, Anil Kumar Shukla, Harini Boppiah. Role of Transabdominal Sonography as a Screening Tool in Prostatic Diseases. Internal journal on scientific study. 2014;2(7):136-146.
- Spajic B, Eupic H, Tomas D, Stimac G, Kruslin B, Kraus O. The Incidence of Hyperechoic Prostate Cancer in Transrectal Ultrasound–Guided Biopsy Specimens. Urology. 2007;70(4):734-737.
- Praveen Kumar P. Chavadi CV. Role of Transrectal ultrasonography and Per rectal examination in the evaluation of prostatic disease: a comparative study International Journal of Biomedical Research [serial on the Internet]. 2015 March 30; [Cited 2015 September 27]; 6(3):[about ## p.]. Available from: http://www.ssjournals.com/index.php/ijbr/article/view/1764
- R Malik, VK Pandya, D Naik. Transrectal ultrasonography for evaluation of various benign and malignant prostatic lesions and their histopathological correlation. Indian journal of radiology imaging. 2004;14 (2):155-157
- Abu-Yousef M. Benign prostatic hyperplasia: tissue characterization using suprapubic ultrasound. Radiology. 1985;156(1):169-173.
- Rifkin M, Friedland G, Shortliffe L. Prostatic evaluation by transrectal endosonography: detection of carcinoma. Radiology. 1986;158(1):85-90.
- Griffiths G, Clements R, Jones D, Roberts E, Peeling W, Evans K. The ultrasound appearances of prostatic cancer with histological correlation. Clinical Radiology. 1987;38(3):219-227.
- Lee H, Lee H, Byun S, Lee S, Hong S, Kim S. Classification of Focal Prostatic Lesions on Transrectal Ultrasound (TRUS) and the Accuracy of TRUS to Diagnose Prostate Cancer. Korean Journal of Radiology. 2009;10(3):244.
- Cho J, Kim S, Lee S. Peripheral Hypoechoic Lesions of the Prostate: Evaluation with Color and Power Doppler Ultrasound. European Urology. 2000;37(4):443-448.
- B Adhira. Diagnosis of Carcinoma Prostate Based on Transrectal Ultrasound Doppler Findings Validated Against Transrectal Ultrasound Guided Biopsy. Journal of Medical Science And clinical Research [Internet]. 2017;05(03):19170-19175. Available from: https://dx.doi.org/10.18535/jmscr/v5i3.135
- Sarkar S, Das S. A Review of Imaging Methods for Prostate Cancer Detection. Biomedical Engineering and Computational Biology. 2016;:1.
- Louvar E, Littrup P, Goldstein A, Yu L, Sakr W, Grignon D. Correlation of color doppler flow in the prostate with tissue microvas-cularity. Cancer. 1998;83(1):135-140.
- Huang ST, Hsieh ML: Evaluation of resistance index in patients with prostate cancer. Anticancer Res.28(4A),1985–1988 (2008).
Corresponding Author
Dr Sajitha K
Additional Professor in Radiodiagnosis Govt Medical College , Kottayam, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.164
