Diagnostic Accuracy of Doppler Ultrasound in Diagnosis of Prostatic Neoplastic Etiology Recognizing Histopathology as the Gold Standard

Abstract

Objective: To utilize histopathology as the gold standard, ascertain the diagnostic accuracy of doppler ultrasound in
the detection of prostatic neoplasm utilizing histopathology as gold standard.
Methodology: Study was conducted at the Radiology Department Rawalpindi Medical University from 20th
September 2021 to 19th February 2022. A cross-sectional descriptive type, consisting of 157 male patients aged
between 50 to 80 years with elevated prostatic serum antigen (PSA) and prostatomegaly on trans-abdominal
ultrasonography. Patients, who have previously been diagnosed with prostate cancer, took chemotherapy for
primary or secondary cancers and h/o radiation therapy were excluded. Trans-abdominal gray-scale and doppler
ultrasound examinations were performed and gray-scale trans rectal ultrasound (TRUS) was performed on patients
with inconclusive trans-abdominal ultrasound. Representative photos with any focal lesions were recorded. Biopsy
was performed with TRUS or transurethral resection of prostate (TURP) and follow up with biopsy report.
Results: 80 (True Positive) of the 88 individuals with Doppler USG positivity for prostate cancer had the disease, while
only 8 (False Positive) did not, according to histopathology. Among 69 patients who tested negative for Doppler USG,
13 (False Negative) had prostate cancer on histology, while 56 (True Negative) did not. Sensitivity, specificity, positive
predictive value, negative predictive value, and diagnostic accuracy of conjunct Doppler USG on prostatic lesion was
calculated as 86.02 percent, 87.50 percent, 90.91 percent, 81.16 percent, and 86.62 percent, respectively, using
histopathology as the gold standard.
Conclusion: Doppler ultrasound is the non-invasive modality of preference with excellent diagnostic accuracy for
identifying prostate cancer.
Keywords: Doppler Ultrasound; Prostate Cancer; Sensitivity