HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kuligowska, E. Articles by Blake, M. Search for Related Content PubMed PubMed Citation Articles by Kuligowska, E. Articles by Blake, M.

Predictors of Prostate Carcinoma: Accuracy of Gray-Scale and Color Doppler US and Serum Markers¹

¹ From the Department of Radiology (E.K., M.A.B.) and the Radiology Fellowship Program (H.M.F., M.B.), Boston University School of Medicine, 88 E Newton St, Boston, MA 02118. Received July 5, 2000; revision requested August 16; final revision received March 29, 2001; accepted March 29. Address correspondence to E.K. (e-mail: ewa.kuligowska@bmc.org).

View larger version (23K): [in a new window]   Figure 1. Coronal schematic diagram of targeted biopsy of suspicious area seen at transrectal US. Arrow indicates area of biopsy sampling.

View larger version (26K): [in a new window]   Figure 2. Coronal schematic representation of sextant biopsy technique, including sampling of both the peripheral and central zones. Arrows indicate areas of biopsy sampling.

View larger version (22K): [in a new window]   Figure 3. Graph shows the correlation of color Doppler US findings with a higher Gleason score. Tumors with a Gleason score of 7 or higher were significantly more likely to be positive than negative at color Doppler US (P < .05). White bars = cases positive at color Doppler US; gray bars = cases negative at color Doppler US.

View larger version (139K): [in a new window]   Figure 4a. US images in a 77-year-old man with elevated PSA levels and pathologic findings of prostate cancer (Gleason score, 6). (a) Transverse gray-scale US image of the prostate apex shows a hypoechoic mass (arrow) on the left. This was identified as a cancer at pathologic examination. (b) Transverse color Doppler US image of the apex depicts increased blood flow (arrow) in the same area as in a.

View larger version (140K): [in a new window]   Figure 4b. US images in a 77-year-old man with elevated PSA levels and pathologic findings of prostate cancer (Gleason score, 6). (a) Transverse gray-scale US image of the prostate apex shows a hypoechoic mass (arrow) on the left. This was identified as a cancer at pathologic examination. (b) Transverse color Doppler US image of the apex depicts increased blood flow (arrow) in the same area as in a.

View larger version (127K): [in a new window]   Figure 5a. US images in a 57-year-old man with a PSA level of 27.0 ng/mL, a predicted PSA level of 8.1 ng/mL, and prostatic adenocarcinoma (Gleason score, 8). (a) Transverse gray-scale US image shows a homogeneous isoechoic mass (arrows) bulging from the right apex. (b) Transverse color Doppler US image demonstrates increased blood flow within the mass (arrows). (c) Transverse gray-scale US image shows the biopsy needle (arrow) within the mass.

View larger version (117K): [in a new window]   Figure 5b. US images in a 57-year-old man with a PSA level of 27.0 ng/mL, a predicted PSA level of 8.1 ng/mL, and prostatic adenocarcinoma (Gleason score, 8). (a) Transverse gray-scale US image shows a homogeneous isoechoic mass (arrows) bulging from the right apex. (b) Transverse color Doppler US image demonstrates increased blood flow within the mass (arrows). (c) Transverse gray-scale US image shows the biopsy needle (arrow) within the mass.

View larger version (121K): [in a new window]   Figure 5c. US images in a 57-year-old man with a PSA level of 27.0 ng/mL, a predicted PSA level of 8.1 ng/mL, and prostatic adenocarcinoma (Gleason score, 8). (a) Transverse gray-scale US image shows a homogeneous isoechoic mass (arrows) bulging from the right apex. (b) Transverse color Doppler US image demonstrates increased blood flow within the mass (arrows). (c) Transverse gray-scale US image shows the biopsy needle (arrow) within the mass.

View larger version (150K): [in a new window]   Figure 6a. US images in a 61-year-old man with an elevated PSA level of 8.0 ng/mL and pathologic findings of prostatic adenocarcinoma (Gleason score, 8). (a) Transverse gray-scale US image reveals heterogeneous echotexture of the prostate. No focal abnormalities are noted. (b) Transverse color Doppler US image shows increased parenchymal flow (arrow) in the right apex of the prostate. (c) Sagittal color Doppler US image shows increased blood flow (arrow) in the right apex, which corresponds to tumor.

View larger version (121K): [in a new window]   Figure 6b. US images in a 61-year-old man with an elevated PSA level of 8.0 ng/mL and pathologic findings of prostatic adenocarcinoma (Gleason score, 8). (a) Transverse gray-scale US image reveals heterogeneous echotexture of the prostate. No focal abnormalities are noted. (b) Transverse color Doppler US image shows increased parenchymal flow (arrow) in the right apex of the prostate. (c) Sagittal color Doppler US image shows increased blood flow (arrow) in the right apex, which corresponds to tumor.

View larger version (106K): [in a new window]   Figure 6c. US images in a 61-year-old man with an elevated PSA level of 8.0 ng/mL and pathologic findings of prostatic adenocarcinoma (Gleason score, 8). (a) Transverse gray-scale US image reveals heterogeneous echotexture of the prostate. No focal abnormalities are noted. (b) Transverse color Doppler US image shows increased parenchymal flow (arrow) in the right apex of the prostate. (c) Sagittal color Doppler US image shows increased blood flow (arrow) in the right apex, which corresponds to tumor.

View larger version (24K): [in a new window]   Figure 7. Graph shows correlation of Gleason score with biopsy method. Targeted biopsy tended to enable identification of tumors with a higher Gleason score. White bars = targeted biopsy, gray bars = sextant biopsy.

View larger version (21K): [in a new window]   Figure 8. Graph shows receiver operating characteristic comparison of the various methods of cancer detection. No single test or combination of tests showed sufficient sensitivity for prostate cancer detection. Routine sextant biopsy, at which all patients were presumed to have tumor prior to biopsy, is represented at the top right corner, with a presumed sensitivity of 1 and a specificity of 0. Bx = biopsy, CDI = color Doppler US, GS = gray-scale US.