title: Results of vardenafil mediated power Doppler ultrasound, contrast enhanced ultrasound and systematic random biopsies to detect prostate cancer.
abstract: OBJECTIVE
  We evaluated the ability of the phosphodiesterase-5 inhibitor vardenafil to increase prostate microcirculation during power Doppler ultrasound. We also evaluated the results of contrast and vardenafil enhanced targeted biopsies compared to those of standard 12-core random biopsies to detect cancer.
  
  
  METHODS
  Between May 2008 and January 2010, 150 consecutive patients with prostate specific antigen more than 4 ng/ml at first diagnosis with negative digital rectal examination and transrectal ultrasound, and no clinical history of prostatitis underwent contrast enhanced power Doppler ultrasound (bolus injection of 2.4 ml SonoVue® contrast agent), followed by vardenafil enhanced power Doppler ultrasound (1 hour after oral administration of vardenafil 20 mg). All patients underwent standard 12-core transrectal ultrasound guided random prostate biopsy plus 1 further sampling from each suspected hypervascular lesion detected by contrast and vardenafil enhanced power Doppler ultrasound.
  
  
  RESULTS
  Prostate cancer was detected in 44 patients (29.3%). Contrast and vardenafil enhanced power Doppler ultrasound detected suspicious, contrast enhanced and vardenafil enhanced areas in 112 (74.6%) and 110 patients (73.3%), and was diagnostic for cancer in 32 (28.5%) and 42 (38%), respectively. Analysis of standard technique, and contrast and vardenafil enhanced power Doppler ultrasound findings by biopsy core showed significantly higher detection using vardenafil vs contrast enhanced power Doppler ultrasound and standard technique (41.2% vs 22.7% and 8.1%, p <0.005 and <0.001, respectively). The detection rate of standard plus contrast or vardenafil enhanced power Doppler ultrasound was 10% and 11.7% (p not significant).
  
  
  CONCLUSIONS
  Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique.
authors.affiliation: Urology Unit, Department of Surgery, University of Pisa, New Santa Chiara Hospital-Cisanello, Pisa, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Morelli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pagni
authors.forename: Chiara
authors.initials: C
authors.lastname: Mariani
authors.forename: Riccardo
authors.initials: R
authors.lastname: Minervini
authors.forename: Andrea
authors.initials: A
authors.lastname: Morelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Gori
authors.forename: Ezio Maria
authors.initials: EM
authors.lastname: Ferdeghini
authors.forename: Marco
authors.initials: M
authors.lastname: Paterni
authors.forename: Eva
authors.initials: E
authors.lastname: Mauro
authors.forename: Elisa
authors.initials: E
authors.lastname: Guidi
authors.forename: Nicola
authors.initials: N
authors.lastname: Armillotta
authors.forename: Domenico
authors.initials: D
authors.lastname: Canale
authors.forename: Paolo
authors.initials: P
authors.lastname: Vitti
authors.forename: Davide
authors.initials: D
authors.lastname: Caramella
authors.forename: Andrea
authors.initials: A
authors.lastname: Minervini
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D003287:Contrast Media; D006801:Humans; D007093:Imidazoles; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply* / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D013450:Sulfones; D014227:Triazines; D018608:Ultrasonography, Doppler; D000069058:Vardenafil Dihydrochloride
chemical_list: D003287:Contrast Media; D007093:Imidazoles; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride