AbstractIntroduction: An accurate and early detection system is urgently needed because prostate cancer is a big problem for older men's health. Unnecessary biopsies are frequently the result of the lack of specificity in traditional diagnostic methods such as prostate-specific antigen (PSA) testing and digital rectal examination (DRE). A potential method that improves the visibility of vascularized lesions is the combination of Power Doppler Imaging (PDI) with TRUS-guided biopsy. The purpose of this research is to determine how well PDI-TRUS-guided biopsy detects prostate cancer.
Materials and Methods: A prospective study was performed on 50 male patients aged 50 to 80 years with probable prostate cancer, indicated by increased PSA levels (≥4 ng/mL) and/or aberrant DRE findings. This study was conducted at the Department of Radiology at Kanti Devi Medical College Hospital and Research Center (KDMC) in Mathura, Uttar Pradesh, India from February 2022 to January 2023. All patients had Power Doppler Imaging-enhanced transrectal ultrasound, succeeded by a systematic 12-core transrectal ultrasound-guided biopsy and supplementary targeted biopsies of hypervascular lesions identified by Power Doppler Imaging. Histopathological examination was conducted to verify malignancy. The diagnostic efficacy of PDI-TRUS-guided biopsy was evaluated against conventional TRUS-guided biopsy.
Results: The histology results showed that 25 out of 50 patients (about 50%) had prostate cancer. Of these instances, 23 were found to have cancer when using PDI-TRUS-guided biopsy, while 19 were found to have cancer when using traditional TRUS-guided biopsy alone (76%). Outperforming conventional TRUS-guided biopsy (p < 0.05), PDI-TRUS-guided biopsy had a sensitivity of 92%, specificity of 86%, positive predictive value (PPV) of 88%, and negative predictive value (NPV) of 90%. PDI improved cancer detection efficiency and reduced false-negative rates by identifying extra hypervascular lesions in 20% of cases.
Conclusion: Traditional TRUS-guided biopsy is not the best method for detecting prostate cancer; power doppler imaging-enhanced TRUS-guided biopsy is. Enhancing diagnostic accuracy and reducing missed malignancies, this approach improves lesion localization by vascular evaluation. According to the results, PDI should be a part of standard procedures for screening for prostate cancer.
