Comparative Efficiency of Contrast-Enhanced Colour Doppler Ultrasound Targeted Versus Systematic Biopsy for Prostate Cancer Detection

Eur Radiol. 2010 Dec;20(12):2791-6. doi: 10.1007/s00330-010-1860-1. Epub 2010 Jun 23.

Abstract

Objective: To compare the efficiency of contrast-enhanced colour Doppler ultrasound (CECD-US) targeted biopsy versus systematic biopsy (SB) for PCa detection in 1,776 men.

Methods: Retrospective, single-centre, diagnostic accuracy study from 2002 until 2006 in 1,776 male volunteers with a serum total PSA of 1.25 ng/ml or greater. In each patient five CECD-US targeted biopsies were performed in hypervascular areas in the peripheral zone during intravenous injection of a second-generation microbubble US contrast agent. Subsequently, another examiner performed ten SBs. The PCa detection rates for the two techniques were compared.

Results: Of 1,776 patients, cancer was detected in 559 patients (31%), including 476 of the 1,776 patients (27%) with CECD-US and 410 (23%) with SB (p < 0.001). The detection rate for CECD-US targeted biopsy cores (10.8% or 961 of 8,880 cores) was significantly better than for SB cores (5.1% or 910 of 17,760 cores, p < 0.001). Among patients with a positive biopsy for PCa, cancer was detected by CECD-US alone in 149 patients (27%) and by SB alone in 83 (15%) (p < 0.001).

Conclusion: This study represents the largest clinical trial to date, demonstrating a significant benefit of CECD-US targeted biopsy relative to SB.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Austria / epidemiology
  • Biopsy, Needle / statistics & numerical data*
  • Contrast Media
  • Humans
  • Male
  • Middle Aged
  • Phospholipids*
  • Prevalence
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / epidemiology*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sulfur Hexafluoride*
  • Ultrasonography, Doppler, Color / methods*
  • Ultrasonography, Interventional / statistics & numerical data*

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride