title: Does the adjunct of ecographic contrast medium Levovist improve the detection rate of prostate cancer?
abstract: 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.
authors.affiliation: Urology Unit, Cannizzaro Hospital, Catania, Italy. piepepe@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Pepe
authors.forename: D
authors.initials: D
authors.lastname: Patanè
authors.forename: P
authors.initials: P
authors.lastname: Panella
authors.forename: F
authors.initials: F
authors.lastname: Aragona
mesh_terms: 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*
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D017430:Prostate-Specific Antigen