Advertisement

Contrast-Enhanced Ultrasonography

  • M. Smeenge
  • M. Mischi
  • M. P. Laguna
  • J. J. M. C. H. de la Rosette
  • H. Wijkstra
Chapter
Part of the Current Clinical Urology book series (CCU)

Abstract

Ultrasound is the cornerstone for prostatic imaging and covers diagnostics, therapy monitoring, and follow-up. In the aspect of focal therapy, accurate prostate cancer localization is mandatory. Contrast-enhanced ultrasound (CEUS) is a promising imaging technique which has shown to greatly increase the chances to find prostate cancer in biopsies. At the moment, CEUS is only performed in expert centers because of difficult interpretation and steep learning curves. CEUS quantification techniques can make reliable and objective interpretation, with a high sensitivity, possible outside of expert centers. Focal therapy and active surveillance are increasingly used, but require to be supported by proper imaging techniques. CEUS seems a promising technique for real-time monitoring and follow-up of focal therapy treatment. In the near future, the use of targeted contrast agents will be a major breakthrough in the combat against prostate cancer. They show promising results regarding better visualization and longer lasting contrast enhancement of prostate cancer in in-vitro as well as in in-vivo animal experiments.

Keywords

Contrast Agent Radical Prostatectomy Harmonic Imaging Power Doppler Ultrasonography Focal Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Bueschen AJ, Lockhart ME. Evolution of urological imaging. Int J Urol. 2011;18:102–12.PubMedCrossRefGoogle Scholar
  2. 2.
    Beemsterboer PM, Kranse R, de Koning HJ, Habbema JD, Schroder FH. Changing role of 3 screening modalities in the European randomized study of screening for PCa (Rotterdam). Int J Cancer. 1999;84:437–41.PubMedCrossRefGoogle Scholar
  3. 3.
    Engelbrecht MR, Barentsz JO, Jager GJ, van der Graaf M, Heerschap A, Sedelaar JP, Aarnink RG, et al. PCa staging using imaging. BJU Int. 2000;86 Suppl 1:123–34.PubMedGoogle Scholar
  4. 4.
    Beerlage HP, Aarnink RG, Ruijter ET, Witjes JA, Wijkstra H, Van De Kaa CA, Debruyne FM, et al. Correlation of transrectal ultrasound, computer analysis of transrectal ultrasound and histopathology of radical prostatectomy specimen. PCa Prostatic Dis. 2001;4:56–62.PubMedCrossRefGoogle Scholar
  5. 5.
    Loch T. Computerized transrectal ultrasound (C-TRUS) of the prostate: detection of cancer in patients with multiple negative systematic random biopsies. World J Urol. 2007;25:375–80.PubMedCrossRefGoogle Scholar
  6. 6.
    Braeckman J, Autier P, Soviany C, Nir R, Nir D, Michielsen D, Treurnicht K, et al. The accuracy of transrectal ultrasonography supplemented with computer-aided ultrasonography for detecting small PCas. BJU Int. 2008;102:1560–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Sedelaar JP, van Leenders GJ, van Leenders GJ, Hulsbergen-van de Kaa CA, van der Poel HG, van der Laak JA, Debruyne FM, Wijkstra H, et al. Microvessel density: correlation between contrast ultrasonography and histology of PCa. Eur Urol. 2001;40:285–93.PubMedCrossRefGoogle Scholar
  8. 8.
    Fregene TA, Khanuja PS, Noto AC, Gehani SK, Van Egmont EM, Luz DA, Pienta KJ. Tumor-associated angiogenesis in PCa. Anticancer Res. 1993;13:2377–81.PubMedGoogle Scholar
  9. 9.
    Sen J, Choudhary L, Marwah S, Godara R, Marwah N, Sen R. Role of colour Doppler imaging in detecting PCa. Asian J Surg. 2008;31:16–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Fleischer AC, Wojcicki WE, Donnelly EF, Pickens DR, Thirsk G, Thurman GB, Hellerqvist CG. Quantified color Doppler sonography of tumor vascularity in an animal model. J Ultrasound Med. 1999;18:547–51.PubMedGoogle Scholar
  11. 11.
    Takahashi S, Yamada Y, Homma Y, Horie S, Hosaka Y, Kitamura T. Power Doppler ultrasonography-directed prostate biopsy in men with elevated serum PSA levels: an evaluation of the clinical utility and limitations. Urology. 2002;60:248–52.PubMedCrossRefGoogle Scholar
  12. 12.
    Sakarya ME, Arslan H, Unal O, Atilla MK, Aydin S. The role of power Doppler ultrasonography in the diagnosis of PCa: a preliminary study. Br J Urol. 1998;82:386–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Kim TK, Lee KH, Khalili K, Jang HJ. Hepatocellular nodules in liver cirrhosis: contrast-enhanced ultrasound. Abdom Imaging. 2011;36:244–63.PubMedCrossRefGoogle Scholar
  14. 14.
    Quaia E. Assessment of tissue perfusion by contrast-enhanced ultrasound. Eur Radiol. 2011;21:604–15.PubMedCrossRefGoogle Scholar
  15. 15.
    Correas JM, Bridal L, Lesavre A, Mejean A, Claudon M, Helenon O. Ultrasound contrast agents: properties, principles of action, tolerance, and artifacts. Eur Radiol. 2001;11:1316–28.PubMedCrossRefGoogle Scholar
  16. 16.
    Schlief R, Alhassan A, Wiggins J, Schumann W, Niendorf HP. Safety of the galactose-based ultrasound contrast agent levovist. Acad Radiol. 2002;9 Suppl 1:S240–2.PubMedCrossRefGoogle Scholar
  17. 17.
    Cohen JL, Cheirif J, Segar DS, Gillam LD, Gottdiener JS, Hausnerova E, Bruns DE. Improved left ventricular endocardial border delineation and opacification with OPTISON (FS069), a new echocardiographic contrast agent. Results of a phase III Multicenter Trial. J Am Coll Cardiol. 1998;32:746–52.PubMedCrossRefGoogle Scholar
  18. 18.
    Bokor D, Chambers JB, Rees PJ, Mant TG, Luzzani F, Spinazzi A. Clinical safety of SonoVue, a new contrast agent for ultrasound imaging, in healthy volunteers and in patients with chronic obstructive pulmonary disease. Invest Radiol. 2001;36:104–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Jakobsen JA, Oyen R, Thomsen HS, Morcos SK. Safety of ultrasound contrast agents. Eur Radiol. 2005;15:941–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Becher H, Lofiego C, Mitchell A, Timperley J. Current indications for contrast echocardiography imaging. Eur J Echocardiogr. 2005;6 Suppl 2:S1–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, Mottet N, et al. EAU guidelines on PCa. part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59:61–71.PubMedCrossRefGoogle Scholar
  22. 22.
    Scattoni V, Raber M, Abdollah F, Roscigno M, Deho F, Angiolilli D, Maccagnano C, et al. Biopsy schemes with the fewest cores for detecting 95% of the PCas detected by a 24-core biopsy. Eur Urol. 2010;57:1–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Frauscher F, Klauser A, Volgger H, Halpern EJ, Pallwein L, Steiner H, Schuster A, et al. Comparison of contrast enhanced color Doppler targeted biopsy with conventional systematic biopsy: impact on PCa detection. J Urol. 2002;167:1648–52.PubMedCrossRefGoogle Scholar
  24. 24.
    Pelzer A, Bektic J, Berger AP, Pallwein L, Halpern EJ, Horninger W, Bartsch G, et al. PCa 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. 2005;173:1926–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Trabulsi EJ, Sackett D, Gomella LG, Halpern EJ. Enhanced transrectal ultrasound modalities in the diagnosis of PCa. Urology. 2010;76:1025–33.PubMedCrossRefGoogle Scholar
  26. 26.
    Halpern EJ, Ramey JR, Strup SE, Frauscher F, McCue P, Gomella LG. Detection of prostate carcinoma with contrast-enhanced sonography using intermittent harmonic imaging. Cancer. 2005;104:2373–83.PubMedCrossRefGoogle Scholar
  27. 27.
    Matsumoto K, Nakagawa K, Hashiguchi A, Kono H, Kikuchi E, Nagata H, Miyajima A, et al. Contrast-enhanced ultrasonography of the prostate with Sonazoid. Jpn J Clin Oncol. 2010;40:1099–104.PubMedCrossRefGoogle Scholar
  28. 28.
    Sano F, Terao H, Kawahara T, Miyoshi Y, Sasaki T, Noguchi K, Kubota Y, et al. Contrast-enhanced ultrasonography of the prostate: various imaging findings that indicate PCa. BJU Int. 2011;107: 1404–10.PubMedCrossRefGoogle Scholar
  29. 29.
    Goossen TE, De La Rosette JJ, Hulsbergen-van de Kaa CA, van Leenders GJ, Wijkstra H. The value of dynamic contrast enhanced power Doppler ultrasound imaging in the localization of PCa. Eur Urol. 2003;43:124–31.PubMedCrossRefGoogle Scholar
  30. 30.
    Kuenen MP, Mischi M, Wijkstra H. Contrast-ultrasound diffusion imaging for localization of PCa. IEEE Trans Med Imaging. 2011;30: 1493–502.PubMedCrossRefGoogle Scholar
  31. 31.
    Zhu Y, Chen Y, Jiang J, Wang R, Zhou Y, Zhang H. Contrast-enhanced harmonic ultrasonography for the assessment of PCa aggressiveness: a preliminary study. Korean J Radiol. 2010;11:75–83.PubMedCrossRefGoogle Scholar
  32. 32.
    Wondergem N, De La Rosette JJ. HIFU and cryoablation–non or minimal touch techniques for the treatment of PCa. Is there a role for contrast enhanced ultrasound? Minim Invasive Ther Allied Technol. 2007;16:22–30.PubMedCrossRefGoogle Scholar
  33. 33.
    Rouviere O, Glas L, Girouin N, Mege-Lechevallier F, Gelet A, Dantony E, Rabilloud M, et al. PCa ablation with transrectal high-intensity focused ultrasound: assessment of tissue destruction with contrast-enhanced US. Radiology. 2011;259:583–91.PubMedCrossRefGoogle Scholar
  34. 34.
    Atri M, Gertner MR, Haider MA, Weersink RA, Trachtenberg J. Contrast-enhanced ultrasonography for real-time monitoring of interstitial laser thermal therapy in the focal treatment of PCa. Can Urol Assoc J. 2009;3:125–30.PubMedGoogle Scholar
  35. 35.
    Fischer T, Thomas A, Tardy I, Schneider M, Hunigen H, Custodis P, Beyersdorff D, et al. Vascular endothelial growth factor receptor 2-specific microbubbles for molecular ultrasound detection of PCa in a rat model. Invest Radiol. 2010;45:675–84.PubMedCrossRefGoogle Scholar
  36. 36.
    Pochon S, Tardy I, Bussat P, Bettinger T, Brochot J. von WM, Passantino L, et al. BR55: a lipopeptide-based VEGFR2-targeted ultrasound contrast agent for molecular imaging of angiogenesis. Invest Radiol. 2010;45:89–95.PubMedCrossRefGoogle Scholar
  37. 37.
    Tardy I, Pochon S, Theraulaz M, Emmel P, Passantino L, Tranquart F, Schneider M. Ultrasound molecular imaging of VEGFR2 in a rat prostate tumor model using BR55. Invest Radiol. 2010;45:573–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Xuan JW, Bygrave M, Valiyeva F, Moussa M, Izawa JI, Bauman GS, Klibanov A, et al. Molecular targeted enhanced ultrasound imaging of flk1 reveals diagnosis and prognosis potential in a genetically engineered mouse PCa model. Mol Imaging. 2009;8:209–20.PubMedGoogle Scholar
  39. 39.
    Zhao HW, Luo JH, Xu HX, Wang DH, Lai YR, Chen MN, Lv JY, et al. The value of contrast-enhanced transrectal ultrasound in predicting the nature of prostate diseases and the gleason score of PCa by a subjective blood flow grading scale. Urol Int. 2011;87:165–70.PubMedCrossRefGoogle Scholar
  40. 40.
    Bangma CH, Roemeling S, Schroder FH. Overdiagnosis and overtreatment of early detected PCa. World J Urol. 2007;25:3–9.PubMedCrossRefGoogle Scholar
  41. 41.
    Schneider M. Molecular imaging and ultrasound-assisted drug delivery. J Endourol. 2008;22:795–802.PubMedCrossRefGoogle Scholar
  42. 42.
    Yoon CS, Park JH. Ultrasound-mediated gene delivery. Expert Opin Drug Deliv. 2010;7:321–30.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  • M. Smeenge
    • 1
  • M. Mischi
    • 2
  • M. P. Laguna
    • 1
  • J. J. M. C. H. de la Rosette
    • 1
  • H. Wijkstra
    • 3
  1. 1.Department of UrologyAMC University HospitalAmsterdamThe Netherlands
  2. 2.Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
  3. 3.Department of Urology/Electrical EngineeringAMC University Hospital/Eindhoven University of TechnologyAmsterdamThe Netherlands

Personalised recommendations