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Value of enhanced transrectal ultrasound targeted biopsy for prostate cancer diagnosis: a retrospective data analysis

World Journal of Urology volume 30, pages 341–346 (2012)Cite this article

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.

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Fig. 1

Abbreviations

RTE:

Real-time sonoelastography

CE-TRUS:

Contrast-enhanced transrectal ultrasound

E-TRUS:

Enhanced transrectal ultrasound

PCa:

Prostate cancer

PSA:

Prostate-specific antigen

TRUS:

Transrectal ultrasound

CPS:

Cadence contrast pulse sequencing

PV:

Prostate volume

References

  1. Gómez Veiga F, Ponce Reixa J, Barbagelata López A, Fernández Rosado E, Gonzaåez Martiñ M (2006) Current role of PSA and other markers in the diagnosis of prostate cancer. Arch Esp Urol 59:1069–1082

    PubMed  Article  Google Scholar 

  2. Naughton CK, Smith DS, Humphrey PA, Catalona WJ, Keetch DW (1998) Clinical and pathologic tumor characteristics of prostate cancer as a function of the number of biopsy cores: a retrospective study. Urology 52:808–813

    PubMed  Article  CAS  Google Scholar 

  3. Loch T (2011) Prostate cancer diagnostics: innovative imaging in case of multiple negative biopsies. World J Urol 29:607–614

    Google Scholar 

  4. Kurhanewicz J, Vigneron D, Carroll P, Coakley F (2008) Multiparametric magnetic resonance imaging in prostate cancer: present and future. Curr Opin Urol 18:71–77

    PubMed  Article  Google Scholar 

  5. Schlemmer HP (2010) Multiparametric MRI of the prostate: method for early detection of prostate cancer? Rofo 182:1067–1075

    PubMed  Article  Google Scholar 

  6. Krouskop TA, Wheeler TM, Kallel F, Garra BS, Hall T (1998) Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging 20:260–274

    PubMed  CAS  Google Scholar 

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

    PubMed  Article  Google Scholar 

  8. Bartsch G, Horninger W, Klocker H, Reissigl A, Oberaigner W, Schönitzer D et al (2001) Prostate cancer mortality after introduction of prostate-specific antigen mass screening in the Federal State of Tyrol, Austria. Urology 58:417–424

    PubMed  Article  CAS  Google Scholar 

  9. Thompson IM, Ernst JJ, Gangai MP, Spence CR (1984) Adenocarcinoma of the prostate: results of routine urological screening. J Urol 132:690–692

    PubMed  CAS  Google Scholar 

  10. van Moorselaar RJ, Voest EE (2002) Angiogenesis in prostate cancer: its role in disease progression and possible therapeutic approaches. Mol Cell Endocrinol 197:239–250

    PubMed  Article  Google Scholar 

  11. Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL et al (2004) Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per millilitre. N Engl J Med 350:2239–2246

    PubMed  Article  CAS  Google Scholar 

  12. Djavan B, Mazal P, Zlotta A, Wammack R, Ravery V, Remzi M et al (2001) Pathological features of prostate cancer detected on initial and repeat prostate biopsy: results of the prospective European Prostate Cancer Detection study. Prostate 47:111–117

    PubMed  Article  CAS  Google Scholar 

  13. Philip J, Manikandan R, Javlé P, Foster CS (2009) Prostate cancer diagnosis: should patients with prostate specific antigen > 10 ng/mL have stratified prostate biopsy protocols? J Urol 181:1922–1925

    PubMed  Article  Google Scholar 

  14. Simon J, Kuefer R, Bartsch G Jr, Volkmer BG, Hautmann RE, Gottfried HW (2008) Intensifying the saturation biopsy technique for detecting prostate cancer after previous negative biopsies: a step in the wrong direction. BJU Int 102:459–462

    PubMed  Article  Google Scholar 

  15. Grabski B, Baeurle L, Loch A, Wefer B, Paul U, Loch T (2011) Computerized transrectal ultrasound of the prostate in a multicenter setup (C-TRUS-MS): detection of cancer after multiple negative systematic random and in primary biopsies. World J Urol 29:573–579

    PubMed  Article  Google Scholar 

  16. Ashley RA, Inman BA, Routh JC, Mynderse LA, Gettman MT, Blute ML (2008) Reassessing the diagnostic yield of saturation biopsy of the prostate. Eur Urol 53:976–981

    PubMed  Article  Google Scholar 

  17. Anastasiadis AG, Lichy MP, Nagele U, Kuczyk MA, Merseburger AS, Hennenlotter J et al (2006) MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 50:738–748

    PubMed  Article  CAS  Google Scholar 

  18. Hambrock T, Somford DM, Hoeks C, Bouwense SA, Huisman H, Yakar D et al (2010) Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol 183:520–527

    PubMed  Article  CAS  Google Scholar 

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Conflict of interest

Ferdinand Frauscher, MD was consultant to Bracco Imaging SpA.

Author information

Affiliations

  1. Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Friedrich Aigner, Werner Jaschke & Ferdinand Frauscher

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

    Georg Schäfer

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

    Georg Schäfer, Eberhard Steiner & Wolfgang Horninger

  4. Department of Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany

    Thomas R. W. Herrmann

  5. Department of Urology and Andrology, LandesKrankenhaus Hall i. T., Hall in Tirol, Austria

    Udo Nagele

  6. Thomas Jefferson Prostate Diagnostic Center, Thomas Jefferson University, Philadelphia, PA, USA

    Ethan J. Halpern

Authors
  1. Friedrich Aigner
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  2. Georg Schäfer
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  3. Eberhard Steiner
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  4. Werner Jaschke
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  5. Wolfgang Horninger
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  6. Thomas R. W. Herrmann
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  7. Udo Nagele
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  8. Ethan J. Halpern
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  9. Ferdinand Frauscher
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Corresponding author

Correspondence to Friedrich Aigner.

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Aigner, F., Schäfer, G., Steiner, E. et al. Value of enhanced transrectal ultrasound targeted biopsy for prostate cancer diagnosis: a retrospective data analysis. World J Urol 30, 341–346 (2012). https://doi.org/10.1007/s00345-011-0809-6

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  • DOI: https://doi.org/10.1007/s00345-011-0809-6

Keywords

  • Prostate
  • Prostatic neoplasms
  • Biopsy
  • Ultrasonography
  • Contrast media
  • Sonoelastography