OBJECTIVES: To compare the value of Power Doppler Sonography (PDS) and B mode sonography in the diagnosis of @entity263 and to assess the value of PDS to specify capsular effraction of the @entity5 . @entity1 AND METHODS: 323 @entity1 were investigated: 41 control subjects allowed the establishment of normal vascular semiology and 282 @entity1 with suspected @entity5 (PSA >4ng/ml). Power Doppler Sonography with 3D reconstruction was used to describe Power Doppler Sonography features of normal or abnormal vessels. Three types of blood supply(a: regular avascular posterior peripheral margin, b: irregular avascular posterior peripheral margin, c: vessels crossing the posterior peripheral margin) were described as a function of the presumed stage of @entity5 (a: intraprostatic, b: undetermined, c: extraprostatic). Comparison with histology was performed on random biopsies without Doppler (282 cases) (median PSA level = 15.8ng/ml), on second biopsies indicated with PDS (72 cases), and radical prostatectomy specimens (63 cases). RESULTS: A @entity5 was diagnosed in 157 of the 282 @entity1 (55.7%) with suspected @entity5 . The overall sensitivity of PDS in the initial diagnosis of @entity263 was 92.4% and its specificity was 72% (versus 87.9% and 57.6% for sonography alone respectively). The negative predictive value of PDS was elevated to 80.6% (p<0.0001). Targeting area presenting @entity1503 in any part of the prostate was useful to detect isoechoic or lesions in @entity1 with first negative biopsy results (in 41 of 72 targeted @entity1 with first negative biopsies with PDS a @entity5 was diagnosed: 58% of these @entity5 had less than 3 positive biopsies and 34% only one positive biopsy). The 3 vascular types a, b, c were evaluated prospectively in the detection of capsular effraction. The presence or absence of vessels crossing the capsule to determine an extracapsular extension was a significant sign (p<0.0001). Capsular effraction was detected in 3 of the 27 cases (11%) of type a @entity5 and in 16 of the 18 cases (87%) of type c @entity5 . CONCLUSION: PDS improves the accuracy of echographic imaging in the diagnosis of @entity5 . Combining first sextant biopsies and targeted areas presenting @entity1503 using PDS can increase @entity5 detection with an optimized number of biopsy cores. The risk of extracapsular involvement can be evaluated by the presence of vessels perforating the capsule.

Value of power doppler and 3D vascular sonography as a method for diagnosis and staging of XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostatic cancer', 'prostate cancer'] @entity1503 :: ('MESH:D006402', 'Disease') :: ['abnormal blood flow']
@entity263 :: (MESH:D011471,Disease) :: ['prostate cancer']
