Quantitative microbubble enhanced transrectal ultrasound as a tool for monitoring hormonal treatment of prostate carcinoma.
BACKGROUND
We quantified changes in prostate carcinoma vascularity treated with anti-androgens using color Doppler and power transrectal ultrasound in combination with microbubble contrast agent Levovist.


METHODS
Thirty-six men with prostate carcinoma were studied at baseline and at intervals during treatment. At each attendance, Levovist((R)) (10 ml, 300 mg/ml) was given as an iv bolus. Using quantitative analysis, we calculated the pre-enhancement scores, arrival time, time to peak, peak value, and area under the time-enhancement curve (AUC). These were compared to pre-treatment values and serial PSA measurements.


RESULTS
The pre-enhancement, peak value, and AUC each showed a marked response with reductions within one week. The average AUC declined to 68% +/- 9% (mean +/- standard error) by week 1, 56% +/- 9% by week 3, and 20% +/- 4% by week 6. A strong correlation with changes in the mean PSA (r = 0.95, P < 0.001) was also measured. In four patients, Doppler indices did not fall with PSA: two patients with the most marked discrepancy relapsed at 6 months.


CONCLUSIONS
The vascular enhancement declined with therapy, similar to PSA. Microbubble enhanced ultrasound can show early response to treatment.
Eckersley
Robert J
RJ
Ultrasound Group, Imaging Sciences Department, Clinical Sciences Centre, Imperial College Medical School, Hammersmith Campus, London, United Kingdom. r.eckersley@ic.ac.uk
Sedelaar
J P Michiel
JP
Blomley
Martin J K
MJ
Wijkstra
Hessel
H
deSouza
Nandita M
NM
Cosgrove
David O
DO
de la Rosette
Jean J M C H
JJ
D000726:Androgen Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D003287:Contrast Media / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011134:Polysaccharides / Q000627:therapeutic use*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D012007:Rectum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
D000726:Androgen Antagonists; D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D017430:Prostate-Specific Antigen