Does the adjunct of ecographic contrast medium Levovist improve the detection rate of prostate cancer?
OBJECTIVE
To evaluate whether the adjunct of an ultrasound contrast medium improves the detection rate of prostate cancer.


METHODS
In 34 patients, scheduled to undergo a trans-perineal extended prostate biopsy, we carried out a color-Doppler ultrasound (CDU) of the prostate before and after i.v. injection of Levovist, an ultrasound contrast medium. Further bioptic samples were taken in the areas where a marked increase in vascularization was noticed.


RESULTS
The overall diagnostic sensitivity, specificity and efficiency were respectively 72.7, 56.2 and 62.9% for transrectal ultrasound (TRUS); 80, 56.2 and 65.3% for CDU and 88.8, 54.5 and 68% for CDU after Levovist injection; 66.5, 72.6 and 65.1% for digito-rectal examination (DRE); 100, 51.4 and 65.4% for total PSA; and 100, 88.8 and 94.3% for PSA free/total. In the 16 patients with prostate carcinoma, the sensitivity of CDU after Levovist was 92.3, 66% for both DRE and TRUS, and 80% for DRE plus TRUS.


CONCLUSIONS
Considering the cost and the results obtained (high sensitivity and low specificity), a routine use of Levovist does not seem indicated in patients undergoing prostatic biopsy. An exception may be represented by patients with both negative DRE and TRUS.
Pepe
P
P
Urology Unit, Cannizzaro Hospital, Catania, Italy. piepepe@hotmail.com
Patanè
D
D
Panella
P
P
Aragona
F
F
D000368:Aged; D001706:Biopsy; D003287:Contrast Media; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D012007:Rectum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000191:economics / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D017430:Prostate-Specific Antigen