The Dattoli Cancer Center uses the most sophisticated Hitachi Scanner with a custom “true” 3-D color flow Doppler application, incorporating advanced, state of the art ultrasound technology called “elastography,” which analyzes tissue densities to differentiate between cancerous and benign tissue. Technically referred to as transrectal ultrasonography (TRUS), this is a technique that projects sound waves off the prostate and surrounding organs to create an image. The sound waves are generated by a probe placed inside the rectum. Transrectal ultrasound imaging can in many cases accurately identify the local spread of cancer through the prostate capsule. The technique is also used for real time guidance in conjunction with seed implants, external radiation therapy, and other treatments (a method pioneered and used only at the Dattoli Cancer Center).
At our institution, color-flow Doppler ultrasound is the standard of practice because it provides enhanced visualization and greater definition compared to the conventional gray-scale technique. While there is an art to interpreting color-flow Doppler images, tumors tend to show increased blood flow or hypervascularity as findings consistent with malignancy. Tumors are growing faster than normal prostate cells and require more blood to nurture their growth. Tumors therefore tend to create blood vessels around them as they grow, and these can be identified by color-flow Doppler ultrasound.
A conventional TRUS (right half of image) typically shows what are called hypoechogenic areas, which are darker shades of gray. A color-flow Doppler ultrasound (left side) may show the same image, but provides additional insight into how much perfusion of blood is going into the region (indicated by the red areas in the image), and can reveal whether just one prostate nodule is involved or if there is more cancer dispersed throughout the gland. Dual monitors allow patients to watch their scans as the doctor collects the images, indicating what he is seeing as they are revealed.
A unique 3-D application gives us the ability to rotate these images in the computer, displaying the most accurate and complete picture of your gland and surrounding organs. Our Center was the first in the world to adapt this 3-D program to color-flow Doppler ultrasound equipment for the diagnosis and treatment of prostate cancer. By incorporating elastography, we are able to further expand our ability to discern cancerous tissues. Elastrography is a dynamic technique that uses ultrasound to provide an estimation of tissue stiffness by measuring the degree of tissue distortion with the application of an external force. Ultrasound elastography is utilized to differentiate malignant from benign lesions.