G e n i t o u r i n a r y I m a g i n g • O r i g i n a l R e s e a r c h Contrast-EnhancedOBJECTIVE. The purpose of our study was to evaluate the usefulness of contrast-enhanced sonography for prostate cancer detection in patients with an indeterminate prostate-specific antigen (PSA) level (4-10 ng/mL) and negative findings on digital rectal examination.SUBJECTS AND METHODS. Forty-eight patients underwent gray-scale, color Doppler, and contrast-enhanced sonography examinations and then sonographically guided biopsy. Contrast-enhanced sonography was performed using Levovist at a mechanical index of 1.1-1.4. The performances of the three methods for cancer detection were compared according to biopsy site and patient.RESULTS. Sensitivity by biopsy site was greater on contrast-enhanced sonography (68%) than on gray-scale (39%) and color Doppler (41%) sonography (p ≤ 0.05), whereas the specificity and overall accuracy by biopsy site (82% and 77% for gray-scale sonography, 84% and 79% for color Doppler sonography, and 83% and 81% for contrast-enhanced sonography, respectively) were not different for the three methods (p > 0.05). The concordance score for sonography and biopsy results by patient was not different for gray-scale (6.4 ± 1.8), color Doppler (6.3 ± 0.6), and contrast-enhanced sonography (6.5 ± 0.7) (p = 0.281).CONCLUSION. Contrast-enhanced sonography could improve only the sensitivity for cancer detection in analysis by biopsy site but did not improve the overall performance of sonography in patients with an indeterminate PSA level and negative digital rectal examination. rostate cancer is a common malignant neoplasm in men. Its incidence has been increasing because of improvements in diagnostic testing, increasing life expectancy, and the presence of environmental carcinogens [1,2]. Although sonography has wisely been used for evaluating the prostate, many reports have shown the limitations of sonography for cancer detection based on its unsatisfactory sensitivity and variable accuracy [3][4][5][6][7][8].Over the past few years, microbubble contrast-enhanced sonography has been introduced as a promising tool that can improve prostate cancer detection. Halpern et al. [1], in an early large study, showed significant improvement of the sensitivity from 38% on gray-scale and color or power Doppler sonography to 65% with contrast-enhanced (CE) sonography. Thereafter, several studies also reported an increased sensitivity of up to 86% [9][10][11][12]. However, the actual merit of sonographic contrast material may be in question because the performance of CE sonography varied in those studies. The variable degree of cancer risk in the study populations of previous studies may be largely responsible for the variable results of those studies; patients with a high PSA level and positive digital rectal examination may have a greater chance of having positive sonographic findings than those with an indeterminate risk of prostate cancer [9][10][11][12][13][14]. Therefore, if CE sonography were shown to have improved ...

As expected from the physiological function of lipoprotein lipase, the primary association of lipoprotein lipase genotypes is with triglyceride and high-density lipoprotein-cholesterol levels. This appears to be the first reported genetic association with the insulin-resistance syndrome and may reflect genotype specific differences in the regulation of lipoprotein lipase by insulin.