title: Contrast-enhanced harmonic ultrasonography for the assessment of prostate cancer aggressiveness: a preliminary study.
abstract: OBJECTIVE
  To determine whether contrast-enhanced harmonic ultrasonography can be used to predict the aggressiveness of prostate cancer.
  
  
  METHODS
  Contrast-enhanced harmonic ultrasonography was performed in 103 patients suspected of prostate cancer before biopsy. Time intensity curves were reconstructed for systematic biopsy sites and sonographic abnormalities. The characteristics of the curves were described using hemodynamic indices including arrival time (AT), time-to-peak (TTP), and peak intensity (PI). The differences of hemodynamic indices between high-grade and low-grade cancer were analyzed and the correlations between the hemodynamic indices and biopsy Gleason score were studied.
  
  
  RESULTS
  Prostate cancer was detected in 41 of 103 patients and there were significant differences in the hemodynamic indices between the biopsy sites of the non-malignant patients and prostate cancer lesions (p < 0.05). The prostate biopsies revealed 154 prostate cancer lesions, including 31 low-grade lesions and 123 high-grade lesions. The hemodynamic indices AT and TTP of high-grade tumors were significantly shorter than those of low-grade tumors (p = 0.001, 0.002). In addition, high-grade peripheral zone (PZ) tumors had higher PI than low-grade PZ tumors (p = 0.009). The PZ prostate cancer Gleason score correlated with PI, AT and TTP, with Spearman correlation coefficients of 0.223, -0.335, and -0.351, respectively (p = 0.013, < 0.001 and < 0.001).
  
  
  CONCLUSIONS
  Contrast-enhanced ultrasound measurements of hemodynamic indices correlate with the prostate cancer Gleason score.
authors.affiliation: Department of Ultrasound in Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, P.R China.
authors.forename: Yunkai
authors.initials: Y
authors.lastname: Zhu
authors.forename: Yaqing
authors.initials: Y
authors.lastname: Chen
authors.forename: Jun
authors.initials: J
authors.lastname: Jiang
authors.forename: Ren
authors.initials: R
authors.lastname: Wang
authors.forename: Yongchang
authors.initials: Y
authors.lastname: Zhou
authors.forename: Huizhen
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D003287:Contrast Media; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging*; D013459:Sulfur Hexafluoride; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride