Results of Vardenafil Mediated Power Doppler Ultrasound, Contrast Enhanced Ultrasound and Systematic Random Biopsies to Detect Prostate Cancer
2011; Lippincott Williams & Wilkins; Volume: 185; Issue: 6 Linguagem: Inglês
10.1016/j.juro.2011.02.014
ISSN1527-3792
AutoresG. Morelli, Riccardo Pagni, Chiara Mariani, R. Minervini, Andrea Morelli, Francesco Gori, E.M. Ferdeghini, Marco Paterni, Eva Mauro, Elisa Guidi, Nicola Armillotta, Domenico Canale, Paolo Vitti, Davide Caramella, Andrea Minervini,
Tópico(s)Bladder and Urothelial Cancer Treatments
ResumoNo AccessJournal of UrologyAdult Urology1 Jun 2011Results of Vardenafil Mediated Power Doppler Ultrasound, Contrast Enhanced Ultrasound and Systematic Random Biopsies to Detect Prostate Cancer Girolamo Morelli, Riccardo Pagni, Chiara Mariani, Riccardo Minervini, Andrea Morelli, Francesco Gori, Ezio Maria Ferdeghini, Marco Paterni, Eva Mauro, Elisa Guidi, Nicola Armillotta, Domenico Canale, Paolo Vitti, Davide Caramella, and Andrea Minervini Girolamo MorelliGirolamo Morelli Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy Equal study contribution. More articles by this author , Riccardo PagniRiccardo Pagni Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy Equal study contribution. More articles by this author , Chiara MarianiChiara Mariani Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author , Riccardo MinerviniRiccardo Minervini Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author , Andrea MorelliAndrea Morelli Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author , Francesco GoriFrancesco Gori Department of Mathematics and Statistics, University of Pisa, Pisa, Italy More articles by this author , Ezio Maria FerdeghiniEzio Maria Ferdeghini Institute of Clinical Physiology of National Research Council, Pisa, Italy More articles by this author , Marco PaterniMarco Paterni Institute of Clinical Physiology of National Research Council, Pisa, Italy More articles by this author , Eva MauroEva Mauro Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author , Elisa GuidiElisa Guidi Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author , Nicola ArmillottaNicola Armillotta Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author , Domenico CanaleDomenico Canale Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author , Paolo VittiPaolo Vitti Department of Andrology, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author , Davide CaramellaDavide Caramella Department of Andrology, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author , and Andrea MinerviniAndrea Minervini Department of Urology, University of Florence, Careggi Hospital, Florence, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.014AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the ability of the phosphodiesterase-5 inhibitor vardenafil to increase prostate microcirculation during power Doppler ultrasound. We also evaluated the results of contrast and vardenafil enhanced targeted biopsies compared to those of standard 12-core random biopsies to detect cancer. Materials and Methods: Between May 2008 and January 2010, 150 consecutive patients with prostate specific antigen more than 4 ng/ml at first diagnosis with negative digital rectal examination and transrectal ultrasound, and no clinical history of prostatitis underwent contrast enhanced power Doppler ultrasound (bolus injection of 2.4 ml SonoVue® contrast agent), followed by vardenafil enhanced power Doppler ultrasound (1 hour after oral administration of vardenafil 20 mg). All patients underwent standard 12-core transrectal ultrasound guided random prostate biopsy plus 1 further sampling from each suspected hypervascular lesion detected by contrast and vardenafil enhanced power Doppler ultrasound. Results: Prostate cancer was detected in 44 patients (29.3%). Contrast and vardenafil enhanced power Doppler ultrasound detected suspicious, contrast enhanced and vardenafil enhanced areas in 112 (74.6%) and 110 patients (73.3%), and was diagnostic for cancer in 32 (28.5%) and 42 (38%), respectively. Analysis of standard technique, and contrast and vardenafil enhanced power Doppler ultrasound findings by biopsy core showed significantly higher detection using vardenafil vs contrast enhanced power Doppler ultrasound and standard technique (41.2% vs 22.7% and 8.1%, p <0.005 and <0.001, respectively). The detection rate of standard plus contrast or vardenafil enhanced power Doppler ultrasound was 10% and 11.7% (p not significant). Conclusions: Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique. References 1 : Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol2007; 18: 581. Google Scholar 2 : The American Cancer Society National Prostate Cancer Detection Project: Findings on the detection of early prostate cancer in 2425 men . Cancer1991; 67: 2949. Google Scholar 3 : Prostate depiction at endorectal MR spectroscopic imaging: investigation of a standardized evaluation system. Radiology2004; 233: 701. Google Scholar 4 : Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. J Urol2000; 164: 400. Link, Google Scholar 5 : Diffusion-weighted imaging of prostate cancer. J Comput Assist Tomogr2005; 29: 149. Google Scholar 6 : Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. Radiology2006; 241: 449. Google Scholar 7 : Multiparametric magnetic resonance imaging in prostate cancer: present and future. Curr Opin Urol2008; 18: 71. Google Scholar 8 : Contrast enhanced ultrasound flash replenishment method for directed prostate biopsies. J Urol2007; 178: 2354. Link, Google Scholar 9 : Urologic imaging for localized prostate cancer in 2007. World J Urol2007; 25: 121. Google Scholar 10 : Contrast-enhanced ultrasonography using cadence-contrast pulse sequencing technology for targeted biopsy of the prostate. BJU Int2009; 103: 458. Google Scholar 11 : Contrast-enhanced ultrasound and prostate cancer; a multicentre European research coordination project. Eur Urol2008; 58: 982. Google Scholar 12 : The adjunctive use of power Doppler imaging in the preoperative assessment of prostate cancer. BJU Int2010; 105: 1237. Google Scholar 13 : Prostate cancer and the role of color Doppler US. Radiology1993; 189: 153. Google Scholar 14 : Power Doppler US: a potentially useful alternative to mean frequency-based color Doppler US. Radiology1994; 190: 853. Google Scholar 15 : Correlation of color Doppler flow in the prostate with tissue microvascularity. Cancer1998; 83: 135. Google Scholar 16 : The nitric oxide pathway in the human prostate: clinical implications in men with lower urinary tract symptoms. World J Urol2008; 26: 603. Google Scholar 17 : Distribution of nitric oxide synthase implies a regulation of circulation, smooth muscle tone, and secretory function in the human prostate by nitric oxide. Prostate1997; 33: 1. Google Scholar 18 : Microvessel density: correlation between contrast ultrasonography and histology of prostate cancer. Eur Urol2001; 40: 285. Google Scholar 19 : Three-dimensional contrast-enhanced power Doppler ultrasonography and conventional examination methods: the value of diagnostic predictors of prostate cancer. BJU Int2000; 86: 58. Google Scholar 20 : Dutasteride prior to contrast-enhanced colour Doppler ultrasound prostate biopsy increases prostate cancer detection. Eur Urol2008; 53: 112. Google Scholar 21 : Ultrasound of prostate cancer: recent advances. Eur Radiol2008; 18: 707. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185 Issue 6 June 2011 Page: 2126-2131 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsprostateprostatic neoplasmsultrasonographyDopplerbiopsyvardenafilMetrics Author Information Girolamo Morelli Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy Equal study contribution. More articles by this author Riccardo Pagni Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy Equal study contribution. More articles by this author Chiara Mariani Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author Riccardo Minervini Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author Andrea Morelli Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author Francesco Gori Department of Mathematics and Statistics, University of Pisa, Pisa, Italy More articles by this author Ezio Maria Ferdeghini Institute of Clinical Physiology of National Research Council, Pisa, Italy More articles by this author Marco Paterni Institute of Clinical Physiology of National Research Council, Pisa, Italy More articles by this author Eva Mauro Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author Elisa Guidi Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author Nicola Armillotta Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author Domenico Canale Department of Radiology, University of Pisa, Santa Chiara Hospital, Pisa, Italy More articles by this author Paolo Vitti Department of Andrology, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author Davide Caramella Department of Andrology, New Santa Chiara Hospital-Cisanello, Pisa, Italy More articles by this author Andrea Minervini Department of Urology, University of Florence, Careggi Hospital, Florence, Italy More articles by this author Expand All Advertisement PDF downloadLoading ...
Referência(s)