Prostate cancer detection can be improved by pretreating men with dutasteride prior to biopsy guided by contrast-enhanced color Doppler (CECD) imaging, according to researchers.
Michael Mitterberger, MD, of the Medical University of Innsbruck in Austria and his colleagues tested this approach in 36 men aged 52-74 years with elevated PSA levels. Patients took dutasteride 0.5 mg daily for 14 days preceding biopsy. Before starting dutasteride treatment and seven and 14 days after, investigators performed contrast-enhanced targeted imaging of hypervascular areas of the peripheral zone only.
All 36 men underwent five CECD biopsies and 10 systematic biopsies. The systematic biopsies were performed after the CECD biopsies by an investigator blinded to CECD findings. The systematic biopsies were guided by conventional transrectal ultrasound.
CECD-targeted biopsy cores revealed prostate cancer in 12 patients (33.3%), whereas the systematic biopsies found cancer in six of the 12 patients, the researchers reported in European Urology (2007; published online ahead of print).
The investigators found prostate cancer in 30 (17%) of 180 biopsy cores targeted by CECD compared with 36 (10%) of 360 systemic biopsy cores. Dutasteride reduced prostatic blood flow in benign prostatic tissue, whereas blood flow in regions of prostate cancer was still observed after a 14-day course of dutasteride.
The researchers concluded that the combined approach of CECD and dutasteride pretreatment seems promising for prostate cancer detection.