Directed Biopsy During Contrast-Enhanced Sonography of the Prostate

Halpern, Ethan J.; Frauscher, Ferdinand; Rosenberg, Martin; Gomella, Leonard G.

doi:10.2214/ajr.178.4.1780915

Cited by 74 publications

(34 citation statements)

References 16 publications

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“…The cancer detection rate with transrectal US-guided biopsies was described to be from 10 to 50% in different studies [18,48]. Although our sample size is small, it seems that the obtained results of MRI-guided biopsies are comparable or superior to US-guided biopsies in patients with previously negative US-guided biopsies.…”

Section: Discussionmentioning

confidence: 71%

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

et al. 2004

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The purpose of this study was to examine the feasibility and safety of MR-guided biopsies with a transgluteal approach in patients with uncertain or suspicious prostate lesions. Twenty-five patients with uncertain or suspicious focal prostate lesions detected by high-field MR imaging of the prostate gland using endorectal coil imaging were biopsied with a transgluteal approach in a low-field MRI system (0.2 T, Concerto, Siemens). The procedures were guided using T1-weighted FLASH sequences. The prostate gland was biopsied repeatedly with a coaxial technique through a 15-gauge pencil tip with a 16-gauge biopsy handy (median 3.8 samples per patient). Complications and biopsy findings were documented retrospectively. Using T1-weighted sequences biopsy procedures were performed successfully with MR guidance in all cases without any side effects or complications. The median intervention time was 11.3 min. Pathological findings revealed ten cases of hyperplasia or atrophy, three cases of prostatitis, ten cases of carcinoma and two cases of normal tissue. The clinical follow-up showed that in two patients prostate cancer was missed at MR-guided biopsy. Transgluteal MR-guided biopsy of the prostate gland is a safe and promising approach for histological clarification of uncertain or suspicious lesions.

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Section: Discussionmentioning

confidence: 71%

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

et al. 2004

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“…These reports demonstrate not only a high diagnostic potential and reliability of CE-US, but also a high safety profile of US-CAs; in adults, anaphylactoid reactions have been reported at a low rate of less than 0.002% [53,54]. The established indications are oncological, traumatic or inflammatory lesions, assessment of vascular patency or pathology, tissue perfusion, echocardiography, intraoperative guidance and transplant queries [32,[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70].…”

Section: Discussionmentioning

confidence: 99%

Application of a second-generation US contrast agent in infants and children—a European questionnaire-based survey

Riccabona

2012

Pediatr Radiol

100

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Background No US contrast agent (US-CA) is currently licensed for use in children.Objective To survey the off-label use in children of a second-generation US-CA. Materials and methods Questionnaires were e-mailed to European paediatric radiologists, who were asked about their experience with the second-generation US-CA Sonovue® (Bracco, Milan, Italy). Number of examinations per indication and adverse effects were recorded. Examinations were categorised by intravenous or intracavitary use of US-CA. Results Out of 146 respondents, 88 stated that they did not perform contrast-enhanced US in children, but 36 of these (44%) would appreciate paediatric approval. Fortyfive centres reported 5,079 examinations in children (age mean: 2.9 years; range: birth-18 years, M/F: 1/ 2.8). The majority (4,131 [81%] in 29 centres) were intravesical applications. The minority (948 [19%] in 30 centres) were intravenous applications. No adverse effects had been recorded from intravesical use. Six minor adverse effects (skin reaction, unusual taste, hyperventilation) had been recorded after five intravenous studies (0.52%). Conclusion Responses suggest a favourable safety profile of this second-generation US-CA in children. It also demonstrates a demand for such US-CA from paediatric radiologists.

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“…Although CE sonography does not seem to affect the performance of sonography for cancer detection in this study, we suggest that improved sensitivity for cancer detection according to biopsy site may be helpful in guiding sonographically guided biopsy. Previous studies have shown that CE sonographically guided targeted biopsy detects as many cancers as systemic biopsy with fewer than half the number of biopsy cores and that a combination of CE sonographytargeted biopsy and systemic biopsy could increase the cancer detection rate [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…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 performance over gray-scale or color Doppler sonography for the detection of cancer in a strictly designed patient population with indeterminate risk, the impact of CE sonography would become much stronger.…”

Section: Contrast-enhancedmentioning

confidence: 99%

Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

Kim

et al. 2006

American Journal of Roentgenology

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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 ...

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Directed Biopsy During Contrast-Enhanced Sonography of the Prostate

Cited by 74 publications

References 16 publications

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

Application of a second-generation US contrast agent in infants and children—a European questionnaire-based survey

Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

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