To assess the effect of pre-medication of Dutasteride, a dual 5-alpha-reductase inhibitor, on prostatic blood flow prior prostate biopsy and the impact on prostate cancer detection.

12 patients with elevated PSA (>= 1.25 ng/mL and free-to-total ratio of < 18%) were treated with Dutasteride 14 days prior prostate biopsy. Contrast-enhanced color Doppler ultrasound (US) was performed before and 14 days after Dutasteride treatment. Contrast-enhanced targeted biopsies (<= 5) were performed into hypervascular areas of the outer gland only. Subsequently a second investigator performed 10 systematic biopsies. The changes in prostatic blood flow and the impact on prostate cancer detection were evaluated.

Dutasteride reduces prostatic blood flow in benign prostatic tissue, whereas in prostate cancer areas blood flow is still observed after a 14 day course of Dutasteride intake. 4 patients (33.3%) of our cohort were found to have suspicious blood flow and prostate cancer, and 2 cancers (16.6%) were detected solely by targeted contrast-enhanced biopsy.

Dutasteride reduces prostatic blood flow in benign tissue, whereas cancerous areas are still hypervascular after a 14 day intake of Dutasteride. Therefore, pre-medication of Dutaseride seems promising to improve prostate cancer detection by using contrast-enhanced color Doppler US.