title: Novel contrast-enhanced ultrasound imaging in prostate cancer.
abstract: OBJECTIVE
  The purposes of this paper were to present the current status of contrast-enhanced transrectal ultrasound imaging and to discuss the latest achievements and techniques now under preclinical testing.
  
  
  OBJECTIVE
  Although grayscale transrectal ultrasound is the standard method for prostate imaging, it lacks accuracy in the detection and localization of prostate cancer. With the introduction of contrast-enhanced ultrasound (CEUS), perfusion imaging of the microvascularization became available. By this, cancer-induced neovascularisation can be visualized with the potential to improve ultrasound imaging for prostate cancer detection and localization significantly. For example, several studies have shown that CEUS-guided biopsies have the same or higher PCa detection rate compared with systematic biopsies with less biopsies needed.
  
  
  METHODS
  This paper describes the current status of CEUS and discusses novel quantification techniques that can improve the accuracy even further. Furthermore, quantification might decrease the user-dependency, opening the door to use in the routine clinical environment. A new generation of targeted microbubbles is now under pre-clinical testing and showed avidly binding to VEGFR-2, a receptor up-regulated in prostate cancer due to angiogenesis. The first publications regarding a targeted microbubble ready for human use will be discussed.
  
  
  CONCLUSIONS
  Ultrasound-assisted drug delivery gives rise to a whole new set of therapeutic options, also for prostate cancer. A major breakthrough in the future can be expected from the clinical use of targeted microbubbles for drug delivery for prostate cancer diagnosis as well as treatment.
authors.affiliation: Department of Urology, AMC University Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. M.smeenge@amc.uva.nl
authors.forename: Martijn
authors.initials: M
authors.lastname: Smeenge
authors.forename: Massimo
authors.initials: M
authors.lastname: Mischi
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Laguna Pes
authors.forename: Jean J M C H
authors.initials: JJ
authors.lastname: de la Rosette
authors.forename: Hessel
authors.initials: H
authors.lastname: Wijkstra
mesh_terms: D003287:Contrast Media; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D012007:Rectum; D014463:Ultrasonography / Q000379:methods
chemical_list: D003287:Contrast Media