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Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens.

Abstract

OBJECTIVES
This study was designed to identify factors that influenced the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography (CETRUS).
METHODS
139 patients suspected of prostate cancer were evaluated with CETRUS followed by systematic and targeted transrectal ultrasound-guided biopsies. The degree of enhancement of the lesions was objectively measured using peak intensity with time-intensity curve analysis software. Ultrasound findings were correlated with clinical characteristics as well as biopsy and radical prostatectomy findings.
RESULTS
Prostate cancers were detected in 230 biopsy sites from 91 patients. The mean peak intensity value of prostate cancer was significantly higher than that of the benign lesions (9.82 ± 3.73 vs 7.51 ± 2.97; p<0.001), and the peak intensity value of the cancer foci varied across the prostate. The mixed model analysis revealed that the location and Gleason score of tumour foci were the influencing factors of the peak intensity value, and the former had a stronger influence upon peak intensity than the latter (p=0.000 and 0.040, respectively). However, age, prostate volume or serum prostate-specific antigen of the patient had no significant influence on the peak intensity value (p>0.05). Furthermore, the peak intensity value of tumours larger than 5 mm diameter was significantly higher than tumours of 5 mm or smaller diameter (9.28 ± 2.46 vs 6.69 ± 2.65; p<0.001).
CONCLUSIONS
The prostate cancer lesions with a higher Gleason score and larger tumour size which were located in the lateral peripheral zone (PZ) were more likely to show a marked enhancement. Lesions with lower peak intensity that are located in the medial PZ should also be treated as suspicious.

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  • Publisher Full Text
  • Authors

    Jiang J, Chen YQ, Zhu YK, Yao XH, Qi J

    Institution

    Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.

    Source

    The British journal of radiology 85:1019 2012 Nov pg e979-86

    MeSH

    Aged
    Aged, 80 and over
    Contrast Media
    Humans
    Image-Guided Biopsy
    Male
    Middle Aged
    Phospholipids
    Prostate
    Prostate-Specific Antigen
    Prostatectomy
    Prostatic Hyperplasia
    Prostatic Neoplasms
    Sulfur Hexafluoride

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22700257