Contrast-enhanced sonography for prostate cancer detection in patients with indeterminate clinical findings.
OBJECTIVE
The purpose of our study was to evaluate the usefulness of contrast-enhanced sonography for prostate cancer detection in patients with an indeterminate prostate-specific antigen (PSA) level (4-10 ng/mL) and negative findings on digital rectal examination.


METHODS
Forty-eight patients underwent gray-scale, color Doppler, and contrast-enhanced sonography examinations and then sonographically guided biopsy. Contrast-enhanced sonography was performed using Levovist at a mechanical index of 1.1-1.4. The performances of the three methods for cancer detection were compared according to biopsy site and patient.


RESULTS
Sensitivity by biopsy site was greater on contrast-enhanced sonography (68%) than on gray-scale (39%) and color Doppler (41%) sonography (p > or = 0.05), whereas the specificity and overall accuracy by biopsy site (82% and 77% for gray-scale sonography, 84% and 79% for color Doppler sonography, and 83% and 81% for contrast-enhanced sonography, respectively) were not different for the three methods (p > 0.05). The concordance score for sonography and biopsy results by patient was not different for gray-scale (6.4 +/- 1.8), color Doppler (6.3 +/- 0.6), and contrast-enhanced sonography (6.5 +/- 0.7) (p = 0.281).


CONCLUSIONS
Contrast-enhanced sonography could improve only the sensitivity for cancer detection in analysis by biopsy site but did not improve the overall performance of sonography in patients with an indeterminate PSA level and negative digital rectal examination.
Yi
Ahn
A
Department of Radiology, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea.
Kim
Jeong Kon
JK
Park
Seong Ho
SH
Kim
Kyoung Won
KW
Kim
Ho Sung
HS
Kim
Jung Hoon
JH
Eun
Hyo Won
HW
Cho
Kyoung-Sik
KS
D000368:Aged; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D003287:Contrast Media; D017430:Prostate-Specific Antigen