Contrast enhanced ultrasound flash replenishment method for directed prostate biopsies.

Authors

• Robert A Linden
• Edouard J Trabulsi
• Flemming Forsberg
• Paul R Gittens
• Leonard G Gomella
• Ethan J Halpern

Publication/Presentation Date

12-1-2007

Abstract

PURPOSE: We evaluated prostate cancer detection with contrast enhanced ultrasound of the prostate using MicroFlow Imaging (Toshiba America Medical Systems, Tustin, California) compared to systematic biopsy.

MATERIALS AND METHODS: A total of 60 patients referred for prostate biopsy were evaluated with pre-contrast and contrast enhanced MicroFlow Imaging transrectal ultrasound. MicroFlow Imaging is a flash replenishment technique that uses high power flash pulses to destroy contrast microbubbles, followed by low power pulses to demonstrate contrast replenishment. A composite image depicting the vascular architecture is constructed through maximum intensity capture of temporal data in consecutive low power images. Using MicroFlow Imaging up to 5 directed biopsy cores were obtained from areas of abnormal vascular enhancement or morphology, followed by a systematic 10-core biopsy protocol.

RESULTS: A biopsy positive for cancer was found in 79 of the 825 cores (10%) from 18 of the 60 subjects (30%). Positive biopsies were obtained in 50 of 600 systematic core biopsies (8.3%) and in 29 of 225 directed cores (13%) (OR 2.02, p = 0.034). Five of the 18 patients diagnosed with cancer were identified only by systematic biopsy, 2 were identified only by directed biopsy with MicroFlow Imaging and 11 were identified by the 2 techniques (p >0.25). Twice the number of patients was detected per core with directed vs systematic biopsy (0.058 vs 0.027).

CONCLUSIONS: The vascular detail provided by MicroFlow Imaging allowed directed biopsy of these areas with increased detection of prostate cancer. Although a minority of cancers were not detected with MicroFlow Imaging directed biopsy, this technique detected twice as many patients with prostate cancer per biopsy core.

Volume

178

Issue

6

First Page

2354

Last Page

2358

ISSN

1527-3792

Published In/Presented At

Linden, R. A., Trabulsi, E. J., Forsberg, F., Gittens, P. R., Gomella, L. G., & Halpern, E. J. (2007). Contrast enhanced ultrasound flash replenishment method for directed prostate biopsies. The Journal of urology, 178(6), 2354–2358. https://doi.org/10.1016/j.juro.2007.08.022

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

17936814

Department(s)

Administration and Leadership

Document Type

Article