Background: Prostate carcinoma is the fifth leading cause of death from cancer in men, accounting for about 6.6% of the total deaths in men Objectives: To evaluate the efficacy of transrectal ultrasonography in differentiating benign from malignant lesions and to assess the additional advantage of colour doppler when used in conjunction with grey scale ultrasonography.

Methodology: A prospective study was conducted in the Department of Radio diagnosis, Government Medical College, Kottayam for a period of 18 months from April 2016 to October 2017. Study population included 122 male patients with clinical symptoms or digital rectal examination suspicious of prostatic disease and / or patients with raised PSA [PSA>4ng/ml] The final imaging results were correlated with trus guided 12 core biopsy specimens or aspirated samples in cases where imaging findings were suggestive of abscess.

Results: Of the 122 cases studied, malignancy was found in 40.1% of cases and benign diseases were found in 59.9% of cases. The sensitivity, specificity, PPV and NPV in our study with transrectal ultrasound versus colour doppler are 75.51% vs 73.47%, 75.34% vs 80.82%, 67.27% vs 72% and 82.09% vs 81.94 %. Conjunction of colour doppler with grey scale ultrasound resulted in increase in sensitivity by 5% [81.63%], specificity by 3%.[78.08%],

Conclusion: Transrectal ultrasound grey scale with Colour doppler imaging findings alone are not sufficient for completely excluding malignancy. It can be used as an adjunct in evaluating suspicious lesions and as a screening modality to perform targeted biopsy in elderly debilitated males who cannot withstand a regular biopsy.

Keywords: Transrectal Ultrasound; Colour doppler; Resistive Index; Prostatic carcinoma.

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Dr Sajitha K

Additional Professor in Radiodiagnosis Govt Medical College , Kottayam, India