Tuesday, June 1, 2004

Next Generation Prostate Ultrasound Studies Debut at Dattoli Cancer Center

Accurately diagnosing prostate cancer is essential to successful treatment. The widely used PSA blood test is only an indication of the relative health of the prostate gland, and as recent studies indicate, a low PSA can give a false sense of security to as many as 15% of men reporting them. The walnut-sized gland, deep in the man’s lower abdomen presents physical exam challenges because of its position in close proximity to many critical structures – such as the bladder, rectum and seminal vessels.

A biopsy is the definitive test for diagnosing prostate cancer. Most biopsies are performed utilizing ultrasound equipment which portrays images in hues of grey – the “grey scale.” Using this outdated method, biopsies are randomly spaced to obtain 6-12 cores. Since the cancer generally cannot be seen on a grey scale, this is something of a needle-in-a-haystack approach.

The color-flow Doppler prostate ultrasound, introduced to the West coast of Florida 4 years ago with the opening of our Cancer Center, brought a new perspective to diagnosing prostate cancers. The Doppler technology reveals in brilliant color areas of increased blood flow within the gland, indicating sites of suspected tumor growth. This information is profoundly important in planning the prostate biopsy, as it gives the physician color “targets” for the biopsy cores. Without this advanced study, randomly spaced biopsy cores often miss a cancer entirely and subject the man to repeat biopsies as the PSA level continues to rise. Precious time can be lost as inaccurate, costly and painful biopsies are repeated.

As good as the Doppler ultrasound is, until now is it has not been able to give a complete picture of the gland because of its two-dimensional nature and limited 3-D capabilities. With the addition of a brand new Sonocubic computer program, we are now able to look at the Doppler images in true 3-D. Areas of suspected tumor growth can be fully assessed from 360 degrees using this pioneering software. A three-dimensional and transparent model of the man’s prostate is created by the computer, adding greatly to the information needed prior to performing the all important biopsy. This model can be rotated on the monitor to view the transparent structure from all sides – actually making the technology 4-D.

Dattoli Cancer Center is the first installation of this software anywhere in the world. We expect this technology to greatly enhance our ability to accurately diagnose, stage and treat prostate cancers.

Michael J. Dattoli, MD