title: Value of contrast-enhanced sonography with micro flow imaging in the diagnosis of prostate cancer.
abstract: BACKGROUND
  To evaluate the effectiveness of contrast-enhanced sonographic micro flow imaging (MFI) in the diagnosis of prostate cancer.
  
  
  METHODS
  A total of 74 patients referred for prostate biopsy were prospectively evaluated with MFI. The abnormalities were categorized into four patterns: pattern 1: indistinct separation between the inner and outer gland; pattern 2: asymmetrical or focally increased enhancement in the outer gland; pattern 3: enhancement with focal defect; pattern 4: enhancement in the outer gland equal to that of the inner gland. The findings were correlated with Gleason scores.
  
  
  RESULTS
  Prostate cancer was detected in 264 sites in 41 patients. The sensitivity, specificity, accuracy, and positive and negative predictive values for MFI were 81.1%, 84.3%, 83.3%, 68.6%, and 91.3%, respectively. Positive predictive values for the four patterns were 46.0 (pattern 1), 53.6 (pattern 2), 94.3 (pattern 3), and 95.4 (pattern 4). Gleason scores of cancers with patterns 3 (7.09) or 4 (7.51) were significantly higher than those with patterns 1 (6.17) or 2 (6.59) (p = 0.001, p = 0.005, p < 0.001, p < 0.001).
  
  
  CONCLUSIONS
  Some MFI patterns had high positive predictive values and were associated with more aggressive cancers. This could be used to reduce the number of biopsy sites and detect clinically significant cancers.
authors.affiliation: Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd., Shanghai, China 200127.
authors.forename: Shao Wei
authors.initials: SW
authors.lastname: Xie
authors.forename: Feng Hua
authors.initials: FH
authors.lastname: Li
authors.forename: Hong Li
authors.initials: HL
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Du
authors.forename: Jian Guo
authors.initials: JG
authors.lastname: Xia
authors.forename: Hua
authors.initials: H
authors.lastname: Fang
authors.forename: Juan Jie
authors.initials: JJ
authors.lastname: Bo
authors.forename: Jian Shan
authors.initials: JS
authors.lastname: Zhu
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D003287:Contrast Media; D019160:Endosonography / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen