Value of contrast-enhanced sonography with micro flow imaging in the diagnosis of prostate cancer

• Published in: Journal of clinical ultrasound Vol. 39; no. 7; pp. 371 - 377
• Main Authors: Xie, Shao Wei, Li, Feng Hua, Li, Hong Li, Du, Jing, Xia, Jian Guo, Fang, Hua, Bo, Juan Jie, Zhu, Jian Shan
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.09.2011
• Subjects: Aged; Biopsy; Biopsy, Needle; Contrast Media; contrast-enhanced ultrasonography; Endosonography - methods; Glands; Humans; Image Enhancement - methods; imaging; Male; micro flow imaging; Microcirculation; Middle Aged; Neoplasm Staging; Prospective Studies; Prostate cancer; Prostate-Specific Antigen - analysis; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Sensitivity and Specificity; Ultrasound
• ISSN: 0091-2751; 1097-0096; 1097-0096
• DOI: 10.1002/jcu.20841

Background. To evaluate the effectiveness of contrast‐enhanced sonographic micro flow imaging (MFI) in the diagnosis of prostate cancer. Methods. A total of 74 patients referred for prostate biopsy were prospectively evaluated with MFI. The abnormalities were categorized into four patterns: pattern 1: indistinct separation between the inner and outer gland; pattern 2: asymmetrical or focally increased enhancement in the outer gland; pattern 3: enhancement with focal defect; pattern 4: enhancement in the outer gland equal to that of the inner gland. The findings were correlated with Gleason scores. Results. Prostate cancer was detected in 264 sites in 41 patients. The sensitivity, specificity, accuracy, and positive and negative predictive values for MFI were 81.1%, 84.3%, 83.3%, 68.6%, and 91.3%, respectively. Positive predictive values for the four patterns were 46.0 (pattern 1), 53.6 (pattern 2), 94.3 (pattern 3), and 95.4 (pattern 4). Gleason scores of cancers with patterns 3 (7.09) or 4 (7.51) were significantly higher than those with patterns 1 (6.17) or 2 (6.59) (p = 0.001, p = 0.005, p < 0.001, p < 0.001). Conclusions. Some MFI patterns had high positive predictive values and were associated with more aggressive cancers. This could be used to reduce the number of biopsy sites and detect clinically significant cancers. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound, 2011