Contrast-enhanced ultrasound can detect almost three times as many higher-grade prostate cancers using half a many needle biopsies compared with systematic biopsy methods, a study found.

In a randomized, double-blind, placebo-controlled trial, Ethan J. Halpern, MD, and collaborators at Thomas Jefferson University and Hospitals in Philadelphia graded contrast-enhanced ultrasound findings and used them to direct targeted biopsy (up to six cores per prostate).

A blinded 12-core systematic biopsy was subsequently performed on each study participant (272 of the 311 men randomized completed the study). Of the 118 patients with positive biopsies, contrast-enhanced ultrasound with microbubbles detected significantly more higher-volume/higher-grade prostate tumor than did conventional biopsies (55% vs. 17%), Dr. Halpern’s group reported online in the Journal of Urology.

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Although preliminary studies have suggested that pretreatment with a 5-alpha reductase inhibitor may improve the efficiency of contrast-enhanced ultrasound targeted biopsy, dutasteride pretreatment had no significant impact on cancer detection.