title: A prospective randomized trial comparing contrast-enhanced targeted versus systematic ultrasound guided biopsies: impact on prostate cancer detection.
abstract: BACKGROUND
  We performed a prospective randomized trial comparing 5 contrast-enhanced color Doppler (CECD) ultrasound (US) targeted biopsy cores to 10 gray-scale US guided systematic biopsy (SB) cores to determine the impact on the cancer detection rate.
  
  
  METHODS
  We prospectively randomized 100 prostate specific antigen (PSA) screening volunteers with an elevated PSA (> or =1.25 ng/ml and free-to-total PSA < 18%) to undergo contrast-enhanced targeted or SB. Contrast-enhanced targeted biopsies with a limited number of five cores were performed into hypervascular areas of the peripheral zone (PZ) during administration of the US contrast agent SonoVue (Bracco, Italy). A subjective grading of the vascularity from 0 to 3 was used: grade 0, no color signal; 1, low density; 2, medium density; and 3, high density of color signals. Ten SBs were obtained in a standard spatial distribution. Cancer detection rates were compared in the groups.
  
  
  RESULTS
  Cancer was detected in 16/50 subjects (32%) by targeted biopsy, and in 13/50 patients (26%) with SB. The cancer detection rate was significantly better for the targeted approach (P < 0.04, McNemar). The detection rate for targeted biopsy cores (15.6% or 39/250 cores) was significantly better than for SB cores (6.8% or 34/500 cores, P < 0.001, McNemar).
  
  
  CONCLUSIONS
  CECD targeted biopsy detected more cancers than SB with a reduced number of biopsy cores.
authors: Department of Urology, Medical University Innsbruck, Innsbruck, Austria. michael.mitterberger@uibk.ac.at
authors: Michael
authors: M
authors: Mitterberger
authors: Wolfgang
authors: W
authors: Horninger
authors: Alexandre
authors: A
authors: Pelzer
authors: Hannes
authors: H
authors: Strasser
authors: Georg
authors: G
authors: Bartsch
authors: Patrizia
authors: P
authors: Moser
authors: Ethan J
authors: EJ
authors: Halpern
authors: Johann
authors: J
authors: Gradl
authors: Friedrich
authors: F
authors: Aigner
authors: Leo
authors: L
authors: Pallwein
authors: Ferdinand
authors: F
authors: Frauscher
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color
chemical_list: D017430:Prostate-Specific Antigen