title: Value of enhanced transrectal ultrasound targeted biopsy for prostate cancer diagnosis: a retrospective data analysis.
abstract: OBJECTIVE
  To evaluate enhanced transrectal ultrasound (E-TRUS) techniques including real-time sonoelastography (RTE) and contrast-enhanced transrectal ultrasound (CE-TRUS) for prostate cancer (PCa) detection in men with elevated prostate-specific antigen (PSA) serum levels.
  
  
  METHODS
  A total of 133 men with elevated PSA serum levels (≥1.25 ng/mL) showed PCa suspicious lesions on E-TRUS. RTE was done to assess tissue elasticity, and hard areas of the peripheral zone were considered suspicious for malignancy. CE-TRUS was done with cadence contrast pulse sequencing (CPS) technique to assess tumor neoangiogenesis, which were defined as areas with increased and rapid contrast enhancement in the peripheral zone and were considered suspicious for malignancy. All patients underwent an E-TRUS-targeted biopsy of the prostate into the suspected lesions. PCa detection rates for E-TRUS were analyzed.
  
  
  RESULTS
  PCa detection rate of E-TRUS-targeted biopsy was 59.4% (79/133) using a median of 5 cores per patient and a median of 3 cores per lesion. RTE showed a per patient detection rate of 56.5% (70/124) and CE-TRUS of 74.2% (69/93). The subgroup analysis demonstrated the highest detection rates in prostate volumes <40 mL (72.2%) and in men older than 70 years (87%).
  
  
  CONCLUSIONS
  The combined use of CE-TRUS and RTE is feasible and allows for targeted biopsy and may improve PCa detection.
authors.affiliation: Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. friedrich.aigner@uki.at
authors.forename: Friedrich
authors.initials: F
authors.lastname: Aigner
authors.forename: Georg
authors.initials: G
authors.lastname: Schäfer
authors.forename: Eberhard
authors.initials: E
authors.lastname: Steiner
authors.forename: Werner
authors.initials: W
authors.lastname: Jaschke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
authors.forename: Thomas R W
authors.initials: TR
authors.lastname: Herrmann
authors.forename: Udo
authors.initials: U
authors.lastname: Nagele
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Halpern
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003199:Computer Systems; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000379:methods*
chemical_list: D017430:Prostate-Specific Antigen