Echocolor and power Doppler in prostate carcinoma. Does a diagnostic pattern really exist?

Objectives: The echocolour and power-Doppler pattern of prostate carcinoma has not been precisely defined yet and no full agreement has been reached on this topic. This lack of certainty has repercussions on the decision to use echocolour and power Doppler in the diagnosis of prostate carcinoma and, most of all, in the guidance for prostate biopsy. The aim of this study is to assess the echocolour and power Doppler pattern in a series of patients with prostate carcinoma. Materials and methods: 70 patients were studied with rectal exploration for suspected neoplasia and hypoechogenic areas at transrectal ultrasound. The following ultrasound guided biopsies resulted to be positive for adenocarcinoma with a Gleason score between 3 and 10. Results: In 40 cases (57.14%) perilesional vascularisation was found with no or limited intralesional colour signals. In 15 cases (21.4%) hypervascularisation was observed in the neoplastic areas (>3 intralesional colour signals). Fifteen cases (21.4%) showed hypovascularisation of the neoplastic areas or, at least, no vascular alterations were highlighted. In the largest forms (>21 mm) a 34.4% incidence of hypervascularised forms was found. No significant correlation was found between echocolour Doppler patterns and the histological Gleason score on neoplasias. Conclusions: The results of our study agree with the data of the literature on the prevalence of prostate neoplasias with perilesional vascularisation. Since no significantly indicative diagnostic pattern has been found, at present we feel that echocolour and power Doppler do not significantly contribute to the diagnosis of prostate neoplasia or the guidance for bioptic samplings.