Quantitative Parameters To Discriminate Prostate Cancer With Transrectal Doppler And Contrast-enhanced Ultrasonography

Objective: To investigate the value of the quantitative parameters to discriminate prostate cancer with transrectal Doppler and contrast-enhanced ultrasonography.Materials and Methods: (1) Color and power Doppler ultrasonography (PDUS), and the analytic software of color flow were used, and the parameter of peak vascularization index (PVI) in each prostate nodule was recorded. PVI were measured by clolor and power Doppler ultrasonography. Then the differences of PVI in the benign and cancerous nodules were analyzed. (2) The biopsy specimen was stained with CD34 antibody and microvessel density (MVD) was calculated. PVI were measured by PDUS. The correlation between PVI and MVD was analyzed statistically. (3) Contrast Tuned Imaging (CnTI) technique and SW quantitative software were used, and the parameters of the increase in the intensity (a1), decent curvature (a2), ascendant curvature (a3), time of perfusion (t0), time to peak intensity (TTP), peak intensity (PI), arriving time (AT), area under the curve (AUC), amplitude (AMP), mean trasit time (MTT) in each prostate nodule were recorded. Then the differences of these parameters in the benign and cancerous nodules were analyzed. And receiver operating characteristic (ROC) analysis was performed.Result: (1) PVI of 32 prostate cancerous nodules and 35 prostate benign nodules, measured by color Doppler ultrasonography, were (0.38±0.16),(0.24±0.19), respectively. And the former was significantly higher than the latter (P=0.0023). PVI of the cancerous nodules and the benign nodules, measured by PDUS were (0.55±0.18),(0.32±0.21), respectively. And the former was significantly higher than the latter (P<0.0001). As a quantitative parameter to discriminate prostate cancer, PVI measured by PDUS was more effective than that measured by color Doppler (area under the ROC curve, 0.817; 95% confidence interval, 0.704~0.901). (2) There was positive correlation between PVI, measured by PDUS, and MVD in 32 prostate cancerous nodules (r=0.70). (3) The increase in the intensity (a1) of 25 prostate cancerous nodules and 22 prostate benign nodules were (28.49±6.06), (18.26±9.19), respectively. And the former was significantly higher than the latter (P<0.0001). The peak intensity (PI) of the cancerous nodules and the benign nodules were (26.31±7.53), (19.24±8.35), respectively. And the former was significantly higher than the latter (P=0.0042). The amplitude of the intensity (AMP) of the cancerous nodules and the benign nodules were (20.47±5.55), (9.70±6.02), respectively. And the former was significantly higher than the latter (P<0.0001). The mean trasit time(MTT) of the cancerous nodules and the benign nodules were (48.90±12.26), (58.79±9.48), respectively. And the former was significantly lower than the latter (P=0.0040).Conclusion: a1, PI, AMP, MTT are good discriminators for the prostate cancerous nodules and the benign nodules in contrast-enhanced ultrasonography as well as PVI in Doppler ultrasonography. And they may be useful to discriminate prostate cancer with ultrasonography.