Value of contrast-enhanced sonographic micro flow imaging for prostate cancer detection with t-PSA level of 4-10 ng/mL.
OBJECTIVE
To compare the efficiency of contrast-enhanced ultrasonographic micro flow imaging (MFI) with conventional transrectal ultrasound (TRUS) in detecting prostate cancer with serum total prostate-specific antigen (t-PSA) of 4.0-10.0 ng/mL. To evaluate the value of contrast-enhanced ultrasonographic MFI in detecting prostate cancer with t-PSA in diagnostic gray zone.


METHODS
47 patients with t-PSA 4.0-10.0 ng/mL underwent gray scale, power Doppler TRUS and MFI examinations before ultrasound guided biopsies. Biopsies were performed at twelve sites in the base, the mid-gland and the apex of the prostate in each patient, when there was no abnormal ultrasound finding. When an abnormality was present at MFI, the biopsy specimen from the corresponding site was directed toward the abnormal finding. With histological results of prostate biopsy as reference standards, we assessed the cancer detection of these three methods.


RESULTS
564 specimens were collected in this study, in which 101 were prostate cancer confirmed histologically. 152 of 564 specimens were demonstrated abnormal on MFI images, in which 71 were malignant and 81 were benign confirmed histologically. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for MFI in detecting prostate caner were 70.3%, 82.5%, 80.3%, 46.7% and 92.7%, respectively. The sensitivity and NPV for MFI were significantly better than gray scale (38.6%, 86.9%) and power Doppler (32.7%, 86.0%) (P<0.001) TRUS.


CONCLUSIONS
Contrast-enhanced ultrasonographic MFI could significantly improve the detection rate of prostate cancer with t-PSA in diagnostic gray zone (4-10 ng/mL) than conventional ultrasound.
Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd., Shanghai 200127, China. guoyifen@gmail.com
Yi-Fen
YF
Guo
Feng-Hua
FH
Li
Shao-Wei
SW
Xie
Jian-Guo
JG
Xia
Hua
H
Fang
Hong-Li
HL
Li
D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012212:Rheology / Q000379:methods*; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D017430:Prostate-Specific Antigen