This study aims to evaluate the clinical utility of Power Doppler Ultrasonography (PDUS) in the detection of prostate cancer and determine its predictive ability compared to digital rectal examination, serum PSA levels and gray-scale transrectal ultrasonography, using biopsy as the reference standard.

This is a prospective cross-sectional study of 49 consecutive patients, who underwent prostate needle biopsies at the National Kidney and Transplant Institute. All patients were seen at the out-patient department and suspected of having prostate cancer because of abnormally high serum PSA levels (>4 ng/ml) and/or abnormal digital rectal examination. Patients previously diagnosed with prostate cancer were excluded in the study. All patients underwent gray-scale TRUS before power Doppler imaging of the prostate using the Siemens Sonoline Elegra high resolution digital ultrasound with a 6.5 MHz endocavitary probe. After power Doppler imaging, a systematic 1 2-core and lesion-directed TRUS-guided biopsy of the prostate was performed.

A total of 49 patients (mean age 64.45, SD 7.53, range 41-79) were included in this study. Prostate needle biopsy confirmed 15 (30.6%) to have prostate cancer. Of the 15 patients diagnosed with prostate cancer, 5 (33.3%) had an abnormal DRE, 10 (66.7%) had abnormal TRUS findings, 3 (20%) had positive power Doppler flow. PDU had a positive predictive value of 60% and a specificity of 94.1 %. Multivariate logistic regression analysis with the odds ratio computed at 95% C.l. showed that the addition of PDUS to the standard procedure for prostate cancer detection using DRE, serum PSA, and TRUS resulted in a higher sensitivity and better overall predictive performance.

The overall prostate cancer detection rate was 30.6% with a sensitivity of 66.7% for gray-scale TRUS and 20% for power Doppler ultrasonography. PDUS increased the predictive value and specificity of Gray-scale TRUS. The addition of PDUS to the standard procedure for prostate cancer detection using DRE, serum PSA, and TRUS resulted in a higher sensitivity and better overall predictive performance.