Comparative efficiency of contrast-enhanced colour Doppler ultrasound targeted versus systematic biopsy for prostate cancer detection.
OBJECTIVE
To compare the efficiency of contrast-enhanced colour Doppler ultrasound (CECD-US) targeted biopsy versus systematic biopsy (SB) for PCa detection in 1,776 men.


METHODS
Retrospective, single-centre, diagnostic accuracy study from 2002 until 2006 in 1,776 male volunteers with a serum total PSA of 1.25 ng/ml or greater. In each patient five CECD-US targeted biopsies were performed in hypervascular areas in the peripheral zone during intravenous injection of a second-generation microbubble US contrast agent. Subsequently, another examiner performed ten SBs. The PCa detection rates for the two techniques were compared.


RESULTS
Of 1,776 patients, cancer was detected in 559 patients (31%), including 476 of the 1,776 patients (27%) with CECD-US and 410 (23%) with SB (p < 0.001). The detection rate for CECD-US targeted biopsy cores (10.8% or 961 of 8,880 cores) was significantly better than for SB cores (5.1% or 910 of 17,760 cores, p < 0.001). Among patients with a positive biopsy for PCa, cancer was detected by CECD-US alone in 149 patients (27%) and by SB alone in 83 (15%) (p < 0.001).


CONCLUSIONS
This study represents the largest clinical trial to date, demonstrating a significant benefit of CECD-US targeted biopsy relative to SB.
Mitterberger
Michael Josef
MJ
Department of Urology, Medical University Innsbruck, Innsbruck, Austria. michael.mitterberger@i-med.ac.at
Aigner
Friedrich
F
Horninger
Wolfgang
W
Ulmer
Hanno
H
Cavuto
Silvio
S
Halpern
Ethan J
EJ
Frauscher
Ferdinand
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D001707:Biopsy, Needle / Q000706:statistics & numerical data*; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride