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Contrast Enhanced Ultrasound Flash Replenishment Method for Directed Prostate Biopsies

2007; Lippincott Williams & Wilkins; Volume: 178; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2007.08.022

1527-3792

Robert A. Linden, Edouard J. Trabulsi, Flemming Forsberg, Paul Gittens, Leonard G. Gomella, Ethan J. Halpern,

Spectroscopy Techniques in Biomedical and Chemical Research

No AccessJournal of UrologyAdult urology1 Dec 2007Contrast Enhanced Ultrasound Flash Replenishment Method for Directed Prostate Biopsies Robert A. Linden, Edouard J. Trabulsi, Flemming Forsberg, Paul R. Gittens, Leonard G. Gomella, and Ethan J. Halpern Robert A. LindenRobert A. Linden , Edouard J. TrabulsiEdouard J. Trabulsi , Flemming ForsbergFlemming Forsberg , Paul R. GittensPaul R. Gittens , Leonard G. GomellaLeonard G. Gomella , and Ethan J. HalpernEthan J. Halpern View All Author Informationhttps://doi.org/10.1016/j.juro.2007.08.022AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated prostate cancer detection with contrast enhanced ultrasound of the prostate using MicroFlow Imaging (Toshiba America Medical Systems, Tustin, California) compared to systematic biopsy. Materials and Methods: A total of 60 patients referred for prostate biopsy were evaluated with pre-contrast and contrast enhanced MicroFlow Imaging transrectal ultrasound. MicroFlow Imaging is a flash replenishment technique that uses high power flash pulses to destroy contrast microbubbles, followed by low power pulses to demonstrate contrast replenishment. A composite image depicting the vascular architecture is constructed through maximum intensity capture of temporal data in consecutive low power images. Using MicroFlow Imaging up to 5 directed biopsy cores were obtained from areas of abnormal vascular enhancement or morphology, followed by a systematic 10-core biopsy protocol. Results: A biopsy positive for cancer was found in 79 of the 825 cores (10%) from 18 of the 60 subjects (30%). Positive biopsies were obtained in 50 of 600 systematic core biopsies (8.3%) and in 29 of 225 directed cores (13%) (OR 2.02, p = 0.034). Five of the 18 patients diagnosed with cancer were identified only by systematic biopsy, 2 were identified only by directed biopsy with MicroFlow Imaging and 11 were identified by the 2 techniques (p >0.25). Twice the number of patients was detected per core with directed vs systematic biopsy (0.058 vs 0.027). Conclusions: The vascular detail provided by MicroFlow Imaging allowed directed biopsy of these areas with increased detection of prostate cancer. Although a minority of cancers were not detected with MicroFlow Imaging directed biopsy, this technique detected twice as many patients with prostate cancer per biopsy core. References 1 : Cancer statistics, 2007. CA Cancer J Clin2007; 57: 43. Google Scholar 2 : Sensitivity and specificity of sextant biopsies in the detection of prostate cancer: preliminary report. Urology1999; 54: 486. Google Scholar 3 : The appearance of prostate cancer on transrectal ultrasonography: correlation of imaging and pathological examinations. 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Google Scholar Departments of Urology and Radiology (FF, EJH), Jefferson Prostate Diagnostic Center, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHalpern E, Gomella L, Forsberg F, McCue P and Trabulsi E (2012) Contrast Enhanced Transrectal Ultrasound for the Detection of Prostate Cancer: A Randomized, Double-Blind Trial of Dutasteride PretreatmentJournal of Urology, VOL. 188, NO. 5, (1739-1745), Online publication date: 1-Nov-2012.Morelli G, Pagni R, Mariani C, Minervini R, Morelli A, Gori F, Ferdeghini E, Paterni M, Mauro E, Guidi E, Armillotta N, Canale D, Vitti P, Caramella D and Minervini A (2011) Results of Vardenafil Mediated Power Doppler Ultrasound, Contrast Enhanced Ultrasound and Systematic Random Biopsies to Detect Prostate CancerJournal of Urology, VOL. 185, NO. 6, (2126-2131), Online publication date: 1-Jun-2011. Volume 178Issue 6December 2007Page: 2354-2358 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsprostateprostatic neoplasmsultrasonographybiopsymicrobubblesMetrics Author Information Robert A. Linden More articles by this author Edouard J. Trabulsi Financial interest and/or other relationship with Pfizer and Auvern Laboratories. More articles by this author Flemming Forsberg Financial interest and/or other relationship with Toshiba, Imagisonix and Siemens. More articles by this author Paul R. Gittens More articles by this author Leonard G. Gomella More articles by this author Ethan J. Halpern More articles by this author Expand All Advertisement PDF downloadLoading ...