Objectives: This study assessed the effect of premedication with dutasteride, a dual 5 alpha-reductase inhibitor, on prostatic blood flow prior to prostate biopsy and its impact on prostate cancer detection. Methods: Thirty-six patients, aged 52-74 yr, with elevated prostate-specific antigen (PSA) levels (>= 1.25 ng/ml and free-to-total ratio of <18%) were treated with dutasteride 14 d prior to prostate biopsy. Contrast-enhanced colour Doppler (CECD) ultrasound was performed before and 7 and 14 d after dutasteride treatment. Contrast-enhanced targeted biopsies (<= 5) were performed into hypervascular areas of the peripheral zone only. Subsequently, a second investigator performed 10 systematic biopsies of the prostate in a standard spatial distribution guided by conventional grey-scale ultrasonography on a Combison 530MT unit. Results: Dutasteride reduced prostatic blood flow in benign prostatic tissue, whereas in prostate cancer areas blood flow was still observed after a 14-d course of dutasteride intake. A reduction of blood flow was observed even after 7 d. Maximum flow reduction was observed after 14 d. Twelve patients (33%) of our cohort were found to have suspicious blood flow and prostate cancer and six cancers (17%) were detected solely by targeted contrast-enhanced biopsy. Conclusion: Premedication with dutasteride seems promising to improve prostate cancer detection by using CECD ultrasound. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Useful keywords (using NLM MeSH Indexing)
Blood Flow Velocity/drug effects*
Prostatic Neoplasms/drug therapy
Reproducibility of Results
Ultrasonography, Doppler, Color/methods*
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