[The correlations between color Doppler using a contrast medium and the neoangiogenesis of small prostatic carcinomas].
OBJECTIVE
To investigate if the use of a contrast agent (Levovist) improves the specificity of US in the diagnosis of prostate carcinoma, having the results of prostate biopsy as the gold standard.


METHODS
Thirty patients with physical findings suspicious for prostate carcinoma and PSA ranging 5 ng/mL to 15 ng/mL were examined with transrectal US (TRUS) integrated with the color Doppler mode and contrast agent administration (4 g injected at 4 mL/min: 300 mL concentration).


RESULTS
Based on bioptic and surgical results, 14 prostate carcinomas were found, all of them < 1.2 cm. Conventional US recognized the suspected nodule in 11 cases, with 78% sensitivity and 93% specificity. Color Doppler showed color signals in 8/14 cases, which were peripheral to the lesion or intranodular, but did not add any important finding to those of gray-scale US. In contrast, contrast enhanced studies showed 13/14 carcinomas, which improved sensitivity significantly (92%). Particularly, 11/14 lesions had a typical avascular pattern within the strongly enhanced peripheral gland, while 2 small lesions only exhibited intranodular vessels.


CONCLUSIONS
We compared our results with the Microscopic Angiogenesis Grading System (MAGS) index and found it exceeded 30 in the 11 avascular lesions value indicates microneoangiogenesis. In the other two cases a value < 30 was correlated with a different type of tumor vascularization typical of macroangiogenesis.
Lagalla
R
R
Istituto di Radiologia P. Cignolini, Policlinico Universitario P. Giaccone, Palermo.
Caruso
G
G
Urso
R
R
Bizzini
G
G
Marasà
L
L
Miceli
V
V
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002277:Carcinoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000473:pathology; D011134:Polysaccharides; D011467:Prostate / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation / Q000379:methods*; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508