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l Detection l References l |
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 Diagram 1.1, Prostate Cancer
Diagram 1.2, Prostate Capsule Penetration
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Power Doppler
Imaging uses blood flow ultrasound technology and has been shown to accurately
differentiate between cancer and benign prostatic
hypertrophy (1) The sensitivity for malignancy diagnosis varies between 86% and
90% (2,3) Malignant vessels have multiple vascular pedicles and irregular sizes
and distributions (4,5) Power Doppler Imaging is more sensitive than traditional
Color Doppler Imaging (6,7) (Fig. 1.1) The areas to which cancer spreads may
also be evaluated (8) Areas of increased flow are 4.7 times more likely to
contain cancer (9) Patients with low grade cancers may be observed and followed
by this technique (10,11,12) Physicians may choose to use this exam to follow up
previously biopsied, operated or post radiation
patients with elevated PSA levels. Decreased blood flow correlates well with
tumor response to non operative treatments (13) Calculi and abscesses causing
chronic/recurrent prostatitis may be studied and
aspirated (14) Postbiopsy artifacts limit early
usage of MRI scanning
(15) and spectroscopic MRI (16) Tumor hypervascularity
correlates with metastatic potential (17,18,19,20,21)
The prostatic capsular region may be reliably imaged
(22,23) and the spread of cancer through the capsule documented (Fig. 1.2)
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1. Okihara K:
Tohuku
J Exp Med 182:277, 1997 J Ultrasound Med 17:283, 1998
Br J
Urol 82:386, 1998
5. Strum S: Proc Inst Prostate Cancer Research 1998
6. Solbiati G: Superficial Structures Churchill 1996
7. American College of Radiology Standards Guide 2001
8. Bard R: Norris Cancer Center Los Angeles 1999
9: Halpern E: American Journal Radiology 174:623, 2000
10. Okihara K: Br J Urol 84:333, 2000
11. Cosgrove D: Diagnostic Imaging 22:69, 2000
12. Cornud F: American Journal Radiology 174:1161, 2000
13. Bard R: Dept Urology Columbia Presbyterian Med 2001
14. Johns Hopkins Medical Letter 3:3, 2001
15. Cornud F. French J Radiol 49:1187, 2001
16. Bard R: Service D'urologie Hosp Necker Paris 2001
17. Lassau N: American Journal Radiology 178: 1547, 2002
18. Lee F: Prostate Center Symposium Commerce, MI 2002
19. Bahn D: Proc Inst Prostate Cancer Research 5:1, 2002
20. Brown D: Radiology Today 4:16, 2003
21. Bard R: Dept of Radiology, Hosp Necker Paris 2003
22. Sauvain JL: Eur Urol 44:21, 2003
23. Bard R: American Roengtgen Ray Society Miami 2004
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