Prostate biopsies performed with contrast-enhanced ultrasonography (CEUS) may enhance prostate cancer (PCa) detection, according to Japanese researchers.
Hiroji Uemura, MD, PhD, Futoshi Sano, MD, and colleagues at Yokohama City University Medical Center in Yokohama, studied 41 patients who underwent CEUS-guided 12-core prostate biopsies and 13 patients who underwent CEUS of the prostate prior to undergoing radical prostatectomy. CEUS was performed using the intravenous contrast agent Sonazoid. The biopsies were performed because patients had a PSA level of 4 ng/mL or higher, a positive digital rectal examination, or both. For the prostatectomy patients, the researchers compared the results of CEUS imaging with pathological findings obtained by examination of the prostatectomy specimens.
Of the 41 patients who underwent CEUS-guided biopsies, 25 had cancer. Of these, 15 had CEUS findings suggestive of cancer and 10 did not. These two groups showed no significant differences in Gleason score, serum PSA level, and prostate volume.
In the 41 CEUS biopsy patients, PCa was found significantly more frequently at the sites of targeted biopsy where CEUS findings suggested cancer than at sites of systemic biopsy (36.3% vs. 17.7%), the researchers reported online ahead of print in BJU International. The ability of CEUS to detect cancer was greater in patients with PSA levels below 10 ng/mL: The detection rate was 27.3% for CEUS versus 9.5% for systemic biopsy.
With respect to the prostatectomy patients, pathological examination revealed 26 tumors in prostatectomy specimens. The diameters of the 10 CEUS-identified tumors were significantly greater than those of the 16 lesions missed by CEUS (18.7 vs. 5.9 mm).
Study findings suggest that “instead of simply increasing the number of biopsy cores, adding targeted biopsy to systemic biopsy could lead to better detection of cancer with a set number of biopsy specimens.”