L'echo-Doppler puissance est-il un bon temoinde l'agressivite du cancer de la prostate ?

摘要

Purpose. To determine the value of Power Doppler US for thediagnosis of prostate cancer and in the prediction of cancer aggres-siveness. Patients and methods. One hundred and five consecutive patients withPSA > 4 ng/ml and/or abnormal digital rectal exam underwent powerDoppler US prior to biopsy. In addition to biopsies directed to suspis-cious lesion on US, 10 to 12 standard sextant biopsies were obtained.Histologic results were correlated to imaging findings. Results. A hypervascular lesion (enlarged, irregular, serpentine ordisorganized vessels) was present at power Doppler US in 34 patientsand corresponded to cancer in 28 cases. Nineteen cancers showed nodetectable abnormality on power Doppler US. Cancer was present in271 of 1093 cores. After correlation with results from sextant prostatebiopsy, power Doppler showed a sensitivity of 44%, specificity of 96%,positive predictive value of 84% and negative predictive value of 80%.Positive results on power Doppler US were strongly cotrrelated withhigher Gleason scores. Conclusion. Power Doppler US may contribute to the evaluation ofprostate cancer aggressiveness and direct biopsies to more aggressivefoci.