The adjunctive use of power Doppler imaging in the preoperative assessment of prostate cancer
The adjunctive use of power Doppler imaging in the preoperative assessment of prostate cancer
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DOI：
10.1111/j.1464-410x.2009.08958.x
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发表时间：
2010-05-01
影响因子：
4.5
通讯作者：
Shinohara, Katsuto
中科院分区：
文献类型：
--
作者：
Eisenberg, Michael L.;Cowan, Janet E.;Shinohara, Katsuto
PROTETIVETo确定如果连续使用的能量多普勒成像（PDI）可以提供预后效用在前列腺癌的治疗，作为一个准确的预测前列腺癌的临床行为是很重要的，以确定适当的treatment.Patients和METHODS大多数中心依靠直肠指检或经直肠超声检查（TRUS），以评估患者的临床分期。2002年，我们开始使用标准化表格来评估TRUS结果和PDI结果。我们比较了2002年至2007年620例根治性前列腺切除术标本的术前临床表现和病理分析。平均（sd）患者年龄为58（6.6）岁，平均前列腺特异性抗原（PSA）水平为7.0（4.5）ng/mL。在620例标本中，157例（25.3%）在病理学评价中有囊外延伸的证据; 443例（71.5%）男性在TRUS上观察到多血管病变，而177例（28.5%）患者无多血管病变。术前PSA水平、肿瘤分级或分期无差异。此外，基于PDI结果，生化复发率或二次治疗率没有差异。作为一种工具，以帮助定位前列腺肿瘤，PDI提高TRUS的特异性，但并没有提高整体的准确性或sensitivity.CONCLUSIONPDI提供一点预后效用，以评估前列腺癌的风险。然而，PDI可能会提高TRUS识别前列腺肿瘤的特异性，并可能在前列腺癌局部治疗的图像引导中发挥作用。
OBJECTIVETo determine if the adjunctive use of power Doppler imaging (PDI) could provide prognostic utility in the treatment of prostate cancer, as an accurate prediction of the clinical behaviour of prostate cancer is important to determine appropriate treatment.PATIENTS AND METHODSMost centres rely on a digital rectal examination or transrectal ultrasonography (TRUS) to assess the clinical stage of patients. In 2002, we began using a standardized form to evaluate TRUS findings and PDI findings. We compared preoperative clinical findings with those from pathological analysis of 620 radical prostatectomy specimens from 2002 to 2007.RESULTSThe mean (sd) patient age was 58 (6.6) years with a mean prostate-specific antigen (PSA) level of 7.0 (4.5) ng/mL. Of the 620 specimens 157 (25.3%) had evidence of extracapsular extension on pathological evaluation; 443 (71.5%) men had a hypervascular lesion seen on TRUS, while 177 (28.5%) patients had none. There was no difference in preoperative PSA level, grade or stage of tumour. Furthermore, rates of biochemical recurrence or secondary treatment did not differ based on PDI findings. As a tool to help locate prostate tumours, PDI improved the specificity of TRUS but did not improve the overall accuracy or sensitivity.CONCLUSIONPDI provides little prognostic utility to assess risk in prostate cancer. However, PDI might improve the specificity of TRUS in identifying prostate tumours and could have a role in image guidance for focal therapy of prostate cancer.