Contemporary issues in the diagnosis of prostate cancer for the radiologist

Clements, R.

doi:10.1007/s00330-006-0221-6

Cited by 1 publication

(1 citation statement)

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“…A hypoechoic lesion detected in a patient with normal outcome of DRE is cancer in only 7e8% of cases, whereas random bilateral biopsies are more likely to detect cancer than directed biopsies of suspicious hypoechoic lesions [12,13]. To improve detection of prostate cancer and limit the number of biopsy cores, use of US contrast agents has been advocated by several authors [7,8,14]. Pelzer et al have demonstrated that contrastenhanced color Doppler sonography is able to detect lesions that cannot be detected using gray scale US or systematic biopsy [6].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced US of the prostate with time/intensity curves: Preliminary results

Valentino

Matteis

Baleni

et al. 2008

Journal of Ultrasound

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KEYWORDSProstate; Ultrasonography; Contrast media.Abstract Purpose: To evaluate the diagnostic performance of ultrasonography using secondgeneration contrast agent in the study of patients with focal prostate lesions and increased serum prostate-specific antigen (PSA) level. Materials and methods: Six consecutive patients (age range: 72e87 years) with increased PSA (4 ng/ml) underwent transrectal ultrasonography (TRUS) followed by contrast-enhanced ultrasonography (CEUS) with injection of second-generation contrast agent. All patients showed areas of abnormal echostructure suspicious for neoplastic lesions. On the basis of CEUS, a time/intensity curve of the suspected area was compared to that of a normalappearing distant area of the gland and to the results of biopsy of the hypoechoic area. Results: At CEUS two different patterns of enhancement were identified and considered to be significant: pattern 1 characterized by a rapid rise in the time/intensity curve of the suspected area compared with the normal gland. Two out of six patients had this pattern and biopsy showed cancer in the biopsied area. Pattern 2 was characterized by a similar rise in the time/intensity curve of the suspected area compared with the normal gland. Four out of six patients had this pattern and biopsy showed prostatitis in the biopsied area. Conclusions: CEUS using second-generation contrast agent can on the basis of time/intensity curves show differences in vascularization in normal and pathological tissue. Evaluation of the two patterns seems to be useful for identifying areas requiring biopsy, particularly when peripheral hypoechoic areas are observed at TRUS. Our data need to be confirmed in a larger patient population.Sommario Scopo: Determinare la performance diagnostica dell'ecografia con mezzo di contrasto di seconda generazione nello studio delle lesioni focali della prostata nei pazienti con elevati valori sierologici di antigene prostatico specifico. Materiali e metodi: Sei pazienti consecutivi (età 72e87 anni) con elevati valori di antigene prostatico specifico (4 ng/ml) sono stati sottoposti a ecografia transrettale tradizionale seguita da ecografia con mezzo di contrasto. In ogni paziente sono state identificate le aree periferiche di alterata ecostruttura sospette per lesione neoplastica. Queste aree sono state valutate con ecografia con mezzo di contrasto mediante curve di intensità/tempo. I dati ottenuti sono stati confrontati con la biopsia dell'area sospetta. Risultati: L'ecografia con mezzo di contrasto ha consentito di identificare due pattern distinti: pattern 1 caratterizzato da rapida elevazione della curva calcolata a livello della lesione rispetto all'intensità di impregnazione del parenchima adiacente. Due dei sei pazienti con questo pattern hanno dimostrato presenza di lesione neoplastica nell'area sottoposta a biopsia. Pattern 2 caratterizzato da scarsa elevazione della curva rispetto all'intensità dell'impregnazione del parenchima adiacente. I rimanenti 4 dei 6 pazienti esaminati avevano questo pattern e l...

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