title: Value of contrast-enhanced ultrasound and elastography in imaging of prostate cancer.
abstract: OBJECTIVE
  Prostate cancer is the most commonly diagnosed malignancy in men. Gray-scale ultrasound-guided systematic biopsy is the standard of care for prostate cancer detection in men with an elevated prostate-specific antigen or an abnormal digital rectal examination. Systematic biopsy may miss up to 35% of clinically relevant cancers. Color and power Doppler ultrasound, ultrasound contrast agents, and elastography have and will dramatically change the role of ultrasound in prostate cancer diagnosis.
  
  
  RESULTS
  Several reports have demonstrated that contrast-enhanced ultrasound investigations of the blood flow of the prostate allow for prostate cancer visualization and therefore, for targeted biopsies. Comparisons between systematic and contrast-enhanced ultrasound-targeted biopsies have shown that the targeted approach detects more cancers with a lower number of biopsy cores. Furthermore, contrast-enhanced ultrasound has been shown to detect cancers with higher Gleason scores compared with the systematic approach, which seems to improve prostate cancer grading. In addition, elastography is a new ultrasound technique that allows for the assessment of tissue elasticity.
  
  
  CONCLUSIONS
  Contrast-enhanced ultrasound and elastography improve prostate cancer detection and may be useful for prostate cancer grading and staging. Future clinical trials will be needed to determine the promise of these new advances for ultrasound of the prostate evolving into clinical applications.
authors.affiliation: Department of Radiology II, Medical University Innsbruck, Austria.
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Michael
authors.initials: M
authors.lastname: Mitterberger
authors.forename: Johann
authors.initials: J
authors.lastname: Gradl
authors.forename: Friedrich
authors.initials: F
authors.lastname: Aigner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
authors.forename: Hannes
authors.initials: H
authors.lastname: Strasser
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Dieter
authors.initials: D
authors.lastname: zur Nedden
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
mesh_terms: D006801:Humans; D008297:Male; D011467:Prostate / Q000000981:diagnostic imaging*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D014463:Ultrasonography