Quantitative colour Doppler and greyscale ultrasound for evaluating prostate cancer

Khalid Ashi, Brooke Kirkham, Anil Chauhan, Susan M. Schultz, Bonnie J. Brake, Chandra M. Sehgal

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Introduction: Although transrectal ultrasound is routinely performed for imaging prostate lesions, colour Doppler imaging visualizing vascularity is not commonly used for diagnosis. The goal of this study was to measure vascular and echogenic differences between malignant and benign lesions of the prostate by quantitative colour Doppler and greyscale transrectal ultrasound.

Methods: Greyscale and colour Doppler ultrasound images of the prostate were acquired in 16 subjects with biopsy-proven malignant or benign lesions. Echogenicity and microvascular flow velocity of each lesion were measured by quantitative image analysis. Flow velocity was measured over several cardiac cycles and the velocity-time waveform was used to determine microvascular pulsatility index and microvascular resistivity index. The Wilcoxon rank sum test was used to compare the malignant and benign groups.

Results: Median microvascular flow velocity of the malignant lesions was 1.25 cm/s compared to 0.36 cm/s for the benign lesions. Median pulsatility and resistive indices of the malignant lesions were 1.55 and 0.68, respectively versus 6.38 and 1.0 for the benign lesions. Malignant lesions were more hypoechoic relative to the surrounding tissue, with median echogenicity of 0.24 compared to 0.76 for the benign lesions. The differences between the malignant and benign groups for each measurement were significant (p < 0.01).

Conclusion: Marked differences were observed in flow velocity, microvascular pulsatility, microvascular resistance, and echogenicity of prostate cancer measured with quantitative colour Doppler and greyscale ultrasound imaging. Vascular differences measured together with echogenicity have the combined potential to characterize malignant and benign prostate lesions.

Original languageEnglish (US)
Pages (from-to)106-111
Number of pages6
Issue number2
StatePublished - May 2021

Bibliographical note

Funding Information:
We thank Mr. Ted Cary for helping with the preparation of the manuscript. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: NIH grants: R01 CA204446, and R01 EB022612.

Publisher Copyright:
© The Author(s) 2020.


  • Ultrasound
  • colour Doppler
  • prostate cancer
  • quantitative


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