title: The influence of prostate volume on prostate cancer detection using a combined approach of contrast-enhanced ultrasonography-targeted and systematic grey-scale biopsy.
abstract: OBJECTIVE
  To evaluate the influence of prostate volume (PV) on the detection of prostate cancer using a combined approach of contrast-enhanced ultrasonography (CEUS) and grey-scale US-guided systematic biopsy (SB).
  
  
  METHODS
  We evaluated 345 patients with prostate cancer and a total prostate-specific antigen (PSA) level of >/= 1.32 ng/mL (1.32-35.3, mean 6.6). Biopsies were taken by two independent examiners; one took five CEUS (Doppler) targeted biopsies of hypervascular regions in the peripheral zone, and subsequently the other took 10 systematic prostate biopsies. We assessed the cancer detection rates for the five different subgroups of prostate volumes, i.e. <20, 20-30, 30-40, 40-50 and > 50 mL.
  
  
  RESULTS
  Each technique, SB and CEUS, detected 73.4% and 77.1% of all detected cancers, respectively, but there were statistically significant differences in detection rate only in small glands. Only 69.0% and 70.4% of all cancers were detected by SB in glands of <20 and 20-30 mL, respectively, whereas 88.1% and 80.8% were detected by CEUS.
  
  
  CONCLUSIONS
  The prostate cancer detection rate for CEUS was significantly higher in prostates of <30 mL (48.1% of the study population) than for SB. Therefore the combined approach of CEUS and SB allows improved cancer detection in patients with small glands and low total PSA values.
authors.affiliation: Department of Urology, University of Innsbruck, Innsbruck, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Colleselli
authors.forename: Jasmin
authors.initials: J
authors.lastname: Bektic
authors.forename: Georg
authors.initials: G
authors.lastname: Schaefer
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
authors.forename: Michael
authors.initials: M
authors.lastname: Mitterberger
authors.forename: Andrea
authors.initials: A
authors.lastname: Brunner
authors.forename: Christian
authors.initials: C
authors.lastname: Schwentner
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
authors.forename: Alexandre E
authors.initials: AE
authors.lastname: Pelzer
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen