Contrast‐enhanced ultrasonography with contrast‐tuned imaging technology for the detection of prostate cancer: comparison with conventional ultrasonography

• Published in: BJU international Vol. 109; no. 11; pp. 1620 - 1626
• Main Authors: Xie, Shao Wei, Li, Hong Li, Du, Jing, Xia, Jian Guo, Guo, Yi Fen, Xin, Mei, Li, Feng Hua
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Biopsy; Cohort Studies; contrast agent; Contrast Media; detection; Gynecology. Andrology. Obstetrics; Humans; Image Enhancement; Male; Male genital diseases; Medical sciences; Middle Aged; Neoplasm Grading; Nephrology. Urinary tract diseases; Phospholipids; Predictive Value of Tests; Prostate cancer; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Sulfur Hexafluoride; Tumors; Tumors of the urinary system; Ultrasonic imaging; ultrasonography; Ultrasonography, Doppler, Color; Urinary tract. Prostate gland; Sonography; Nephrology; detection; Urinary system disease; Prostate disease; ultrasonography; Malignant tumor; Urology; contrast agent; Technology; Echography; Medical imagery; Diagnosis; Male genital diseases; Prostate cancer; Comparative study; Contrast media; Cancer
• ISSN: 1464-4096; 1464-410X; 1464-410X
• DOI: 10.1111/j.1464-410X.2011.10577.x

Study Type – Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The present study was to perform contrast‐tuned imaging (CnTI) technology to detect prostate cancer and compare the use of CnTI technology for the detection of prostate cancer with conventional ultrasonography. The preliminary data from our study suggested that targeted biopsy of the prostate with CnTI technology could improve the cancer detection and detect higher grade prostate cancers. OBJECTIVES •  To perform contrast‐enhanced ultrasonography (CEUS) using contrast‐tuned imaging (CnTI) technology to detect prostate cancer. •  To evaluate the detection of prostate cancer with CnTI compared with conventional grey‐scale and power Doppler ultrasonography. PAIENTS AND METHODS •  In all, 150 patients referred for prostate biopsy were evaluated using transrectal grey‐scale, power Doppler and CnTI ultrasonography. •  Biopsy was performed at 10 sites in each patient. If an abnormality was found at any of these three ultrasonography examinations, a biopsy specimen was targeted towards from the corresponding site. •  The performances of the three ultrasonography techniques for prostate cancer detection were compared. RESULTS •  Prostate cancer was detected at 383 sites from 73 patients. The combination of these three examinations detected more patients with prostate cancer than grey‐scale (P= 0.002), power Doppler (P= 0.001) or baseline imaging (the combination of grey‐scale and power Doppler; P= 0.031) alone. •  By biopsy site, CnTI had higher sensitivity and accuracy (73.1% and 83.7%) than grey‐scale (50.9%; P < 0.001 and 78.8%; P < 0.001) or power Doppler (48.3%; P < 0.001 and 77.7%; P < 0.001), while the specificity was similar for grey‐scale (88.4%), power Doppler (87.8%) and CnTI (87.3%; P > 0.05 in each case). CnTI had higher sensitivity (73.1% vs 62.9%; P < 0.001), specificity (87.3% vs 82.1%; P < 0.001) and accuracy (83.7% vs 77.2%; P < 0.001) than baseline imaging. •  The mean Gleason score of CnTI‐positive cases was significantly higher than CnTI‐negative cases (7.1 vs 6.3; P= 0.002). CONCLUSIONS •  CEUS using CnTI technology enables a visualization of the microvasculature associated with prostate cancer. •  CnTI technology could be used to guide biopsy and improve the detection rate of prostate cancer. •  CnTI technology was able to detect higher grade prostate cancers.