Contrast-Enhanced Transrectal Ultrasound in Focal Therapy for Prostate Cancer

2018 ◽  
Vol 19 (10) ◽  
Author(s):  
Akbar N. Ashrafi ◽  
Nima Nassiri ◽  
Inderbir S. Gill ◽  
Mittul Gulati ◽  
Daniel Park ◽  
...  
Author(s):  
Maurizio Del Monte ◽  
Stefano Cipollari ◽  
Francesco Del Giudice ◽  
Martina Pecoraro ◽  
Marco Bicchetti ◽  
...  

Objectives: To compare the detection rates of overall prostate cancer (PCa) and clinically significant PCa (csPCa) and the median percentage of cancer per biopsy core between MRI-guided In-bore and MRI-TRUS fusion-targeted biopsy (TBx). Methods: In this retrospective study, 223 patients who underwent prostate multiparametric MRI (mpMRI) and subsequent MR-directed biopsy were included. For PCa and csPCa detection rate (DR), contingency tables were tested via the Pearson’s chi-squared to explore the variance of the outcome distribution. The percentage of cancer per biopsy core was tested with a two-tailed Mann-Withney test. Results: One hundred and seventeen and 106 patients underwent MRI-TRUS fusion or MRI In-bore TBx, respectively. 402 MRI biopsy targets were identified, of which 206 (51.2%) were biopsied with the MRI-TRUS TBx and 196 (48.8%) with the MRI In-bore TBx technique. Per-patient PCa and csPCa detection rates were 140/223 (62.8%) and 97/223 (43.5%), respectively. PCa-DR was 73/117 (62.4%) and 67/106 (63.2%) for MRI-TRUS and MRI In-Bore TBx (p = 0.9), while csPCa detection rate reached 50/117 (42.7%) and 47/106 (44.3%), respectively (p = 0.81). The median per-patient percentage of malignant tissue within biopsy cores was 50% (IQR: 27–65%) for PCa and 60% (IQR: 35–68%) for csPCa, with a statistically significant difference between the techniques. Conclusion No statistically significant difference in the detection rate of MRI In-bore and MRI-TRUS fusion TBx was found. MRI In-bore TBx showed higher per-core percentage of malignant cells. Advances in knowledge MRI In-bore biopsy might impact risk stratification and patient management considering the higher per-core percentage of malignant cells, especially for patients eligible for active surveillance or focal therapy.


2011 ◽  
Vol 29 (3) ◽  
pp. 295-301 ◽  
Author(s):  
Michael Seitz ◽  
Christian Gratzke ◽  
Boris Schlenker ◽  
Alexander Buchner ◽  
Alexander Karl ◽  
...  

В обзоре литературы рассматривается применение различных модальностей трансректального ультразвукового исследования в диагностике рака предстательной железы. Представлена диагностическая эффективность В-режима (включая микроультразвуковое исследование, использующее сверхвысокие частоты), различных методов оценки кровотока (включая микродопплеровское картирование), гистосканирования, эластографии (качественный и количественный анализ), контрастного усиления (качественный и количественный анализ). Показана роль магнитно-резонансного и ультразвукового совмещения (фьюжен) при биопсии предстательной железы. Обсуждаются перспективы объединения различных ультразвуковых методов в мультипараметрическое трансректальное ультразвуковое исследование, возможности создания стандартизированных шкал для описания выявленных изменений. Имеющиеся данные подтверждают, что использование современных технологий трансректального ультразвукового исследования значительно повышает его диагностическую точность, в том числе в выявлении клинически значимого рака предстательной железы. Ключевые слова: трансректальное ультразвуковое исследование (ТРУЗИ), допплеровское исследование, ультразвуковое исследование с контрастным усилением, ультразвуковая эластография, микродопплеровское картирование, микроультразвуковое исследование, мультипараметрическое ультразвуковое исследование, магнитно-резонансное и ультразвуковое совмещение (фьюжен), рак предстательной железы; transrectal ultrasound (TRUS), Doppler ultrasound, contrast-enhanced ultrasound (CEUS), ultrasound elastography, micro-Doppler, micro-ultrasound, multiparametric ultrasound, magnetic resonance/transrectal ultrasound fusion (MRI/TRUS fusion), prostate cancer.


2019 ◽  
Author(s):  
Hong-wei Zhao ◽  
Jian Li ◽  
Jia-Zheng Cao ◽  
Juan Lin ◽  
Zhu Wang ◽  
...  

Abstract Background: To investigate the value of contrast-enhanced transrectal ultrasound (CETRUS) in reducing unnecessary biopsy during prostate cancer screening and predicting biochemical recurrence in patients with localized prostate cancer. Methods:This was a prospective study of patients suspected of prostate cancer who were evaluated with CETRUS followed by prostate biopsy. Prostate blood flow on CETRUS was graded using a 5-point scale. The relationship between CETRUS score and biopsy outcomes was analyzed; Univariate and multi-variate analyses were used to determine the probable prognostic factors with biochemical recurrence in patients with localized prostate cancer underwent radical prostatectomy. Results:A total of 347 patients were enrolled. Prostate cancer was found in 164 patients. A significant positive correlation (r = 0.69, p < 0.001) was found between CETRUS scores and prostate cancer. Using CETRUS score ≥ 2 as the threshold for biopsy could have reduced the number of biopsies by 12.1% (42/347) without missing cancer and spared 23.0% (42/183) of patients from unnecessary biopsy. 77 patients with localized prostate cancer underwent radical prostatectomy and followed up. 17 of 77 patients exhibited biochemical recurrence. The 3-year biochemical recurrence-free survival rates were 86% for patients with CETRUS low scores (≤ 3) and 59% for patients with high scores (> 3; p = 0.015). Multivariate Cox regression analysis showed that CETRUS score was an independent predictor of biochemical recurrence (HR: 7.02; 95% CI: 2.00-24.69; p = 0.002). Conclusions:CETRUS score may be a useful tool to reduce unnecessary biopsy during prostate cancer screening and predict biochemical recurrence of localized prostate cancer after radical prostatectomy.


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