Doppler Spectral Waveform Parameters at Neurovascular Bundle Vessels in Patients with Prostate Biopsy

Overview

Journal J Endourol

Publisher Mary Ann Liebert

Specialties Gastroenterology
Urology

Date 2013 Oct 31

PMID 24168710

Citations 2

Authors

Yuh-Shyan Tsai

Yeong-Chin Jou

Chia-Hong Chen

Chien-Chen Chang

Wen-Horng Yang

Jan-Li Lai

Tzong-Shin Tzai

Affiliations

Soon will be listed here.

Abstract

Introduction And Objectives: There is a need to improve prescreening determination of prostate cancer to better select patients who need biopsy. Such a strategy properly implemented, will decrease the number of negative biopsies for prostate cancer and in turn better balance the risks and morbidity for patients recommended for biopsy. The aim of study is to investigate Doppler spectral waveform parameters of neurovascular bundle (NVB) vessels and determine differences between benign and malignant pathologies.

Patients And Methods: We performed a prospective analysis involving 292 patients who received prostate biopsy for elevated prostate-specific antigen (PSA) values or abnormal digital rectal examination, as well as 174 patients with symptomatic benign prostatic hyperplasia. Doppler spectral waveform (DSW) parameters (peak-systolic velocity [PSV], end-diastolic velocity [EDV], and resistive index [RI]) were measured at bilateral NVB vessels through Doppler transrectal ultrasound at the right lateral decubitus position, compared, and analyzed among patients with benign versus malignant histology for each side.

Results: Overall, both PSV and EDV at malignant sides were significantly higher than those at benign sides, as well as lower RI (all p-values <0.05, unpaired t-test). In subgroup analysis with 93 patients of serum PSA between 10 and 20 ng/mL and 56 patients with one-side malignancy, higher EDV and lower RI were significantly associated with malignancies (all p<0.05). The values of PSV and EDV rather than RI might be influenced by the patients' position and RI by the prostate volume.

Conclusions: In this study, DSW parameters (mainly EDV and RI) at NVB vessels were significantly associated with prostate cancer, particularly in patients with serum PSA of 10-20 ng/mL. It should be in caution that the patients' position and prostate volume may influence the Doppler signal as demonstrated in the current study. These findings can provide more diagnostic information before prostate biopsy.

Citing Articles

Longitudinal Changes in U.S. Parameters of Neurovascular Bundles Suggest Mechanism for Radiation-Induced Erectile Dysfunction.

Janopaul-Naylor J, Liu T, Zhou B, Yang X, McCall N, Patel P Adv Radiat Oncol. 2022; 7(5):100946.

PMID: 35514327 PMC: 9065720. DOI: 10.1016/j.adro.2022.100946.

Novel methods for mapping the cavernous nerves during radical prostatectomy.

Fried N, Burnett A Nat Rev Urol. 2015; 12(8):451-60.

PMID: 26256860 DOI: 10.1038/nrurol.2015.174.

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