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Comparative efficiency of contrast-enhanced colour Doppler ultrasound targeted versus systematic biopsy for prostate cancer detection

  • Ultrasound
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Abstract

Objective

To compare the efficiency of contrast-enhanced colour Doppler ultrasound (CECD-US) targeted biopsy versus systematic biopsy (SB) for PCa detection in 1,776 men.

Methods

Retrospective, single-centre, diagnostic accuracy study from 2002 until 2006 in 1,776 male volunteers with a serum total PSA of 1.25 ng/ml or greater. In each patient five CECD-US targeted biopsies were performed in hypervascular areas in the peripheral zone during intravenous injection of a second-generation microbubble US contrast agent. Subsequently, another examiner performed ten SBs. The PCa detection rates for the two techniques were compared.

Results

Of 1,776 patients, cancer was detected in 559 patients (31%), including 476 of the 1,776 patients (27%) with CECD-US and 410 (23%) with SB (p < 0.001). The detection rate for CECD-US targeted biopsy cores (10.8% or 961 of 8,880 cores) was significantly better than for SB cores (5.1% or 910 of 17,760 cores, p < 0.001). Among patients with a positive biopsy for PCa, cancer was detected by CECD-US alone in 149 patients (27%) and by SB alone in 83 (15%) (p < 0.001).

Conclusion

This study represents the largest clinical trial to date, demonstrating a significant benefit of CECD-US targeted biopsy relative to SB.

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References

  1. Damber JE, Aus G (2008) Prostate cancer. Lancet 371(9625):1710–1721

    Article  PubMed  Google Scholar 

  2. Heidenreich A, Aus G, Bolla M et al (2008) EAU guidelines on prostate cancer. Eur Urol 53:68–80

    Article  PubMed  Google Scholar 

  3. Holm HH, Gammelgaard J (1981) Ultrasonically guided precise needle placement in the prostate and the seminal vesicles. J Urol 125:385–387

    CAS  PubMed  Google Scholar 

  4. Giannarini G, Autorino R, di Lorenzo G (2009) Saturation biopsy of the prostate: why saturation does not saturate. Eur Urol 56:619–621

    Article  PubMed  Google Scholar 

  5. Scattoni V, Zlotta A, Montironi R et al (2007) Extended and saturation prostatic biopsy in the diagnosis and characterisation of prostate cancer: a critical analysis of the literature. Eur Urol 52:1309–1322

    Article  PubMed  Google Scholar 

  6. Scattoni V, Raber M, Abdollah F et al (2010) Biopsy schemes with the fewest cores for detecting 95% of the prostate cancers detected by a 24-core biopsy. Eur Urol 57:1–8

    Article  PubMed  Google Scholar 

  7. Presti JC Jr (2009) Repeat prostate biopsy—when, where, and how. Urol Oncol 27:312–314

    PubMed  Google Scholar 

  8. Presti J Jr (2008) Does the yield of prostate cancer biopsy and repeat biopsy justify the frequency of their use? Nat Clin Pract Urol 5:246–247

    Article  PubMed  Google Scholar 

  9. Presti JC Jr (2007) Prostate biopsy strategies. Nat Clin Pract Urol 4:505–511

    Article  PubMed  Google Scholar 

  10. Pallwein L, Mitterberger M, Gradl J et al (2007) Value of contrast-enhanced ultrasound and elastography in imaging of prostate cancer. Curr Opin Urol 17:39–47

    Article  PubMed  Google Scholar 

  11. Aigner F, Pallwein L, Mitterberger M et al (2009) Contrast-enhanced ultrasonography using cadence-contrast pulse sequencing technology for targeted biopsy of the prostate. BJU Int 103:458–463

    Article  PubMed  Google Scholar 

  12. Linden RA, Trabulsi EJ, Forsberg F et al (2007) Contrast enhanced ultrasound flash replenishment method for directed prostate biopsies. J Urol 178:2354–2358

    Article  PubMed  Google Scholar 

  13. Yakar D, Hambrock T, Hoeks C et al (2008) Magnetic resonance-guided biopsy of the prostate: feasibility, technique, and clinical applications. Top Magn Reson Imaging 19:291–295

    Article  PubMed  Google Scholar 

  14. Ismail M, Gomella LG (2001) Ultrasound for prostate imaging and biopsy. Curr Opin Urol 11:471–477

    Article  CAS  PubMed  Google Scholar 

  15. Pallwein L, Mitterberger M, Pelzer A et al (2008) Ultrasound of prostate cancer: recent advances. Eur Radiol 18:707–715

    Article  PubMed  Google Scholar 

  16. Mitterberger M, Horninger W, Pelzer A et al (2007) A prospective randomized trial comparing contrast-enhanced targeted versus systematic ultrasound guided biopsies: impact on prostate cancer detection. Prostate 67:1537–1542

    Article  PubMed  Google Scholar 

  17. Mitterberger M, Pinggera GM, Horninger W, Bartsch G, Strasser H, Schäfer G, Brunner A, Halpern EJ, Gradl J, Pallwein L, Frauscher F (2007) Comparison of contrast enhanced color Doppler targeted biopsy to conventional systematic biopsy: impact on Gleason score. J Urol 178:464–468

    Article  CAS  PubMed  Google Scholar 

  18. Mitterberger M, Pelzer A, Colleselli D et al (2007) Contrast-enhanced ultrasound for diagnosis of prostate cancer and kidney lesions. Eur J Radiol 64:231–238

    Article  PubMed  Google Scholar 

  19. Ashley RA, Inman BA, Routh JC et al (2008) Reassessing the diagnostic yield of saturation biopsy of the prostate. Eur Urol 53:976–981

    Article  PubMed  Google Scholar 

  20. Kibel AS (2007) Optimizing prostate biopsy techniques. J Urol 177:1976–1977

    Article  PubMed  Google Scholar 

  21. Hata N, Jinzaki M, Kacher D et al (2001) MR imaging-guided prostate biopsy with surgical navigation software: device validation and feasibility. Radiology 220:263–268

    CAS  PubMed  Google Scholar 

  22. Frauscher F, Klauser A, Volgger H et al (2002) Comparison of contrast enhanced color Doppler targeted biopsy with conventional systematic biopsy: impact on prostate cancer detection. J Urol 167:1648–1652

    Article  PubMed  Google Scholar 

  23. Pelzer A, Bektic J, Berger AP et al (2005) Prostate cancer detection in men with prostate specific antigen 4 to 10 ng/ml using a combined approach of contrast enhanced color Doppler targeted and systematic biopsy. J Urol 173:1926–1929

    Article  PubMed  Google Scholar 

  24. Halpern EJ, Ramey JR, Strup SE et al (2005) Detection of prostate carcinoma with contrast-enhanced sonography using intermittent harmonic imaging. Cancer 104:2373–2383

    Article  PubMed  Google Scholar 

  25. Wink M, Frauscher F, Cosgrove D et al (2008) Contrast-enhanced ultrasound and prostate cancer; a multicentre European research coordination project. Eur Urol 54:982–992

    Article  PubMed  Google Scholar 

  26. Colleselli D, Bektic J, Schaefer G et al (2007) The influence of prostate volume on prostate cancer detection using a combined approach of contrast-enhanced ultrasonography-targeted and systematic grey-scale biopsy. BJU Int 100:1264–1267

    Article  PubMed  Google Scholar 

  27. Lagakos SW (2006) The challenge of subgroup analyses—reporting without distorting. N Engl J Med 354:1667–1669

    Article  CAS  PubMed  Google Scholar 

  28. Heijmink SW, Barentsz JO (2007) Contrast-enhanced versus systematic transrectal ultrasound-guided prostate cancer detection: an overview of techniques and a systematic review. Eur J Radiol 63:310–316

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Medical University Innsbruck, Innsbruck, Austria

    Michael Josef Mitterberger & Wolfgang Horninger

  2. Department of Radiology, Medical University Innsbruck, Innsbruck, Austria

    Friedrich Aigner & Ferdinand Frauscher

  3. Department of Medical Statistics, Informatics and Health Economics (MSIG), Medical University Innsbruck, Innsbruck, Austria

    Hanno Ulmer

  4. National Cancer Institute, Milan, Italy

    Silvio Cavuto

  5. Diagnostic Radiology, Jefferson Prostate Diagnostic Center, Thomas Jefferson University, Philadelphia, USA

    Ethan J. Halpern

  6. Department of Urology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Michael Josef Mitterberger

Authors
  1. Michael Josef Mitterberger
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  2. Friedrich Aigner
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  3. Wolfgang Horninger
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  4. Hanno Ulmer
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  5. Silvio Cavuto
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  6. Ethan J. Halpern
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  7. Ferdinand Frauscher
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Corresponding author

Correspondence to Michael Josef Mitterberger.

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Mitterberger, M.J., Aigner, F., Horninger, W. et al. Comparative efficiency of contrast-enhanced colour Doppler ultrasound targeted versus systematic biopsy for prostate cancer detection. Eur Radiol 20, 2791–2796 (2010). https://doi.org/10.1007/s00330-010-1860-1

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  • DOI: https://doi.org/10.1007/s00330-010-1860-1

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