Use of power Doppler ultrasound-guided biopsies to locate regions of tumour hypoxia

Evans, Sydney M.; Laughlin, Kristine M.; Pugh, Charles R.; Sehgal, Chandra M.; Saunders, Helen

doi:10.1038/bjc.1997.553

Cited by 16 publications

(7 citation statements)

References 31 publications

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“…Neovascularization has been reported in many cancers as in prostate cancer. [14][15][16] In our study, cancer was detected in 36% by histopathological evaluation. In many studies performed with different imaging methods, the rate of cancer detection was reported to be 29-53%.…”

Section: Discussionsupporting

confidence: 46%

Contribution of Color Doppler Sonography in the Diagnosis of Prostatic Pathologies.

Sarıca¹

2019

South Clin Ist Euras

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The aim of this study was to investigate the ability of color Doppler ultrasonography to determine prostate cancer, to evaluate the contribution of color Doppler ultrasonography to a conventional greyscale transrectal ultrasonography (TRUS) examination, and to assess the efficacy of prostate-specific antigen (PSA) values in the detection of prostate cancer in combination with sonographic imaging methods. Methods: A total of 78 patients who presented at the Radiology Department of Taksim Training and Research Hospital and were diagnosed with benign prostate hyperplasia or prostate cancer were included in the study. The age range of the patients was 49 to 90 years. A Diasonic VST Master color Doppler ultrasonography system with a 7-Mhz transrectal probe (Diasonic Technology Co. Ltd., Gyeonggi-do, South Korea) was used to assess the patients. The presence and number of nodules; the size, shape, and echo structure of the lesion; the loss of peripheral zone and inner gland border; capsular invasion; seminal vesicle thickening; and obliteration or patency of the prostate seminal vesicle angle as observed in the TRUS examination were noted. A vascularization map of different regions of the prostate gland was evaluated by section. The color flow was graded using a 3-point scale and the findings were compared with the pathology results. Results: Based on the results of a histopathological examination, 28 cases (36%) were malignant and the remaining 50 cases (64%) were benign. The mean PSA density (PSAD) value was 0.41 in the malignant cases and 0.23 in the benign cases. The best results for the diagnosis of prostate cancer were obtained with the combined use of TRUS, color Doppler ultrasound, and PSAD. The sensitivity, specificity, positive, and negative predictive value was 64%, 80%, 64%, and 80%, respectively. Conclusion: The addition of color Doppler ultrasound to TRUS increased the specificity and decreased the sensitivity (from 78% to 51%) of the findings. Though RDUS does not provide a significant advantage in the diagnosis of cancer, the color flow grading better determines the areas to be biopsied. Due to the poor sensitivity of a color Doppler examination, it should be evaluated with grayscale and PSA findings. The best specificity (80%) was observed with the combined use of these 3 methods.

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Section: Discussionsupporting

confidence: 46%

Contribution of Color Doppler Sonography in the Diagnosis of Prostatic Pathologies.

Sarıca¹

2019

South Clin Ist Euras

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“…The finding of biopsies that demonstrate low Photofrin uptake in patients who have little EF5 binding in their disease brings to light the possibility that delivery of both agents may have been limited. However, extensive preclinical evaluation has established that under long incubation times, sufficient concentrations of hypoxia marker are delivered to label even low perfusion areas (31)(32)(33)(34)(35). Additionally, we always see EF5 binding adjacent to regions of necrosis.…”

Section: Discussionmentioning

confidence: 92%

Hypoxia and Photofrin Uptake in the Intraperitoneal Carcinomatosis and Sarcomatosis of Photodynamic Therapy Patients

Busch

Hahn

Wileyto³

et al. 2004

Clinical Cancer Research

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Purpose: Response to photodynamic therapy depends on adequate tumor oxygenation as well as sufficient accumulation of photosensitizer in the tumor. The goal of this study was to investigate the presence of hypoxia and retention of the photosensitizer Photofrin in the tumors of patients with intra-abdominal carcinomatosis or sarcomatosis.Experimental Design: Tumor nodules from 10 patients were studied. In nine of these patients, hypoxia was identified in histological sections of biopsied tumor after administration of the hypoxia marker 2-(2-nitroimidazol-1[H]-yl)-N-(2,2,3,3,3-pentafluoropropyl)acetamide (EF5). In separate tumor nodules from 10 patients, Photofrin uptake was measured by fluorescence after tissue solubilization.Results: Hypoxia existed in the tumors of five patients, with three of these patients demonstrating at least one severely hypoxic nodule. Physiological levels of oxygen were present in the tumors of four patients. An association between tumor size and hypoxia was not evident because some tumor nodules as small as ϳ2 mm in diameter were severely hypoxic. However, even these tumor nodules contained vascular networks. Three patients with severely hypoxic tumor nodules exhibited moderate levels of Photofrin uptake of 3.9 ؎ 0.4 to 3.9 ؎ 0.5 ng/mg (mean ؎ SE). The four patients with tumors of physiological oxygenation did not consistently exhibit high tumor concentrations of Photofrin: mean ؎ SE drug uptake among these patients ranged from 0.6 ؎ 0.8 to 5.8 ؎ 0.5 ng/mg.Conclusions: Carcinomatosis or sarcomatosis of the i.p. cavity may exhibit severe tumor hypoxia. Photofrin accumulation in tumors varied by a factor of ϳ10؋ among all patients, and, on average, those with severe hypoxia in at least one nodule did not demonstrate poor Photofrin uptake in separate tumor samples. These data emphasize the need for reconsideration of the generally accepted paradigm of small tumor size, good oxygenation, and good drug delivery because this may vary on an individual tumor basis.

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“…It has been well-documented that cancers have neovascularity and can incite a vascular response. This has been reported with a variety of cancers as well as with prostate cancer [ 12 - 14 ]. In the present study, histopathological examination revealed a malignancy rate of 32.50%.…”

Section: Discussionmentioning

confidence: 75%

Evaluation of Prostatic Lesions by Transrectal Ultrasound, Color Doppler, and the Histopathological Correlation

Khanduri¹,

Katyal²,

Goyal³

et al. 2017

Cureus

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ObjectiveTo evaluate the role of a transrectal ultrasound (TRUS) guided biopsy and a color Doppler test in the detection of prostate cancer in patients with increased serum prostate-specific antigen (PSA) levels and/or an abnormal digital rectal examination (DRE).MethodA total of 40 cases, ranging in age from 50 to 80 years and showing increased serum PSA levels (4-10 ng/ml) and/or abnormal DRE, were enrolled and underwent TRUS evaluation followed by color Doppler flowmetric studies. A TRUS-guided biopsy was performed in all the cases. The findings were confirmed histopathologically. Data were analyzed using the chi-square test.ResultsHistopathologically, a total of 13 cases (32.5%) were malignant. On TRUS, irregular shape, heterogeneous echotexture loss of differentiation between the peripheral and internal zones, less mean weight of the prostate, and capsular invasion were significantly associated with malignancy. On flowmetry, moderate vascularity and focal asymmetry were significantly associated with malignancy. The combined use of TRUS and color Doppler flowmetry was found to be 100% sensitive and 92.6% specific and had a positive predictive value (PPV) and a negative predictive value (NPV) of 86.7% and 100%, respectively.ConclusionTRUS with color Doppler flowmetry was highly sensitive and specific in the detection of prostate malignancy.

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Use of power Doppler ultrasound-guided biopsies to locate regions of tumour hypoxia

Cited by 16 publications

References 31 publications

Contribution of Color Doppler Sonography in the Diagnosis of Prostatic Pathologies.

Contribution of Color Doppler Sonography in the Diagnosis of Prostatic Pathologies.

Hypoxia and Photofrin Uptake in the Intraperitoneal Carcinomatosis and Sarcomatosis of Photodynamic Therapy Patients

Evaluation of Prostatic Lesions by Transrectal Ultrasound, Color Doppler, and the Histopathological Correlation

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