title: Status of transrectal ultrasound imaging of the prostate.
abstract: OBJECTIVE
  To describe the current and new developments in transrectal ultrasound (US) imaging of the prostate.
  
  
  METHODS
  Grayscale imaging of the prostate is the standard method for diagnostic evaluation and biopsy guidance. Color Doppler (CD) imaging, including CD and power Doppler US, allows for detection of macrovascularity and may therefore be helpful for assessment of prostatic blood flow. The use of US microbubbles for CD imaging and new contrast-specific techniques enable assessment of prostate microvascularity associated with prostate cancer (PCa). Recently, real-time elastography has been introduced to improve detection of cancer based upon changes in tissue stiffness.
  
  
  RESULTS
  Contrast-enhanced CD imaging has shown to enable PCa detection by performing targeted biopsies into suspicious areas. Comparisons between systematic and contrast-enhanced targeted biopsies have shown that the targeted approach detects more cancers and cancers with higher Gleason scores with a reduced number of biopsy cores. New microbubble-specific US techniques can improve sensitivity and specificity of US imaging for PCa detection. Real-time elastography has been demonstrated to be useful for the detection of PCa, and may further improve PCa staging.
  
  
  CONCLUSIONS
  The new US techniques seem to have the potential to improve PCa detection, and also PCa grading and staging. As these diagnostic methods improve, the ultimate hope is to eliminate biopsy in patients without cancer.
authors.affiliation: Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Aigner
authors.forename: Michael
authors.initials: M
authors.lastname: Mitterberger
authors.forename: Peter
authors.initials: P
authors.lastname: Rehder
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Daniel
authors.initials: D
authors.lastname: Junker
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
mesh_terms: D001707:Biopsy, Needle; D003287:Contrast Media; D054459:Elasticity Imaging Techniques; D019160:Endosonography; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011467:Prostate / Q000000981:diagnostic imaging*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D003287:Contrast Media