CHSJ

Curr Health Sci J, vol. 36, no. 4, 2010

Imaging Assessment Of The New Vasculature Of The Prostate Cancer – A Non-Invasive Tool Of Diagnostic And Prognostic

[Original paper]

R. BERISHA (1), A. GEORGESCU (1), A. BONDARI (1), N. BOUTSIADIS(2), K. BOUTSIADIS(3)


(1)Department of Medical Imaging, County Emergency University Hospital, University of Medicine and Pharmacy, Craiova;
(2)"G. Papanikolaou" General Hospital of Thesaloniki,
(3)Theageneio Hospital of Thesaloniki


Abstract:

More than 46% of men older than 50 years could have at least microscopic cancer in their prostate glands. Because the morbidity of treatment may outweigh its benefits, in Europe it is common not to treat for prostate cancer (CaP) asymptomatic men older than 70 years. CaP screening is based on the serum concentration of prostate specific antigen (PSA) and digital rectal examination, which have a low sensibility and are followed by “blind” systematic biopsy with negative results in the most cases. Purpose: To illustrate and present an analysis of the new vasculature features of CaP on Doppler Ultrasound, multidetector enhanced CT and MRI. Materials and methods: We performed a prospective study between June 2008 and July 2010 of the prostate vasculature demonstrated on Doppler US in 53 consecutive patients (range 28-77 years); among them 21 performed MRI exam and/or multislice CT. Results: 21/53 patients presented clinical, biological and/or US abnormal findings and underwent further imaging exams; among them 18 were finally diagnosed with CaP. Another 3 patients with abnormal Doppler US were directly biopsied with malignancy proved in 2 cases. The PPV of Doppler US was 83%. The MRI findings in 19 patients confirmed the abnormal vasculature and further targeted/ surgical biopsies proved malignancy in 17 cases (PPV 89%). Conclusion: CaP presented more vasculature as compared with the non-cancer areas in Doppler US, spiral CT and MRI on the same patient. Even in early stages, when no evident tumor mass was present on the imaging exams, we suspected cancer when the pericapsular vessels were enlarged or presented high flow (Doppler, MRI). MRI had better sensibility, but we agree the Full Prostate Ultrasonography, including Doppler exam and Sono-Elastography, will be soon the best non-invasive, available and low cost imaging method of detection, follow-up and guided targeted biopsy of the CaP.


Keywords: Imagery, Prostate cancer, New vasculature



Corresponding: R. Berisha MD PhD Stud , Department of Medical Imaging, County Emergency University Hospita, University of Medicine and Pharmacy Craiova, Str Petru Rares nr. 4, 200456, Craiova, Dolj, Romania E-mail:berisha_rexhep@yahoo.com; aristida_georgescu@yahoo.com


DOI 10.12865/CHSJ.36.04.06 - Download PDF
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