Significance Of Contrast-enhanced Transrectal Ultrasonography For The Detection Of Prostate Cancer

Objective:To evaluate the value of contrast-enhanced ultrasonography(CEUS)in detecting prostate cancer.Methods:Eighty-one patients with elevated serum prostate-specific antigen(PSA)levels(more than 4.00ng/mL)were evaluated with transrectal ultrasonography(TRUS)and contrast-enhanced transrectal ultrasonography(CE-TRUS),a 10-core systematic biopsy(SB)was subsequently performed at the base,the mid gland and the apex in each patient and the targeted biopsy(TB)was performed at abnormal CE-TRUS or TRUSareas.Diagnostic efficiency of the two techniques for the cancer detection was compared and the targeted biopsy was also compared to systematic biopsy.Results:Prostate cancer was detected in 149(17.0%)of 890 specimens in 35(43.2%)of 81 patients.CE-TRUS could detect 27 patients diagnosed with cancer in 37 patients in whom CE-TRUS showed abnormal.,CE-TRUS had higher sensitivity specificity and overall accuracy(77.1%,78.2%and 77.8%)than TRUS(62.8%,67.3%and 65.4%)(p<0.05,p<0.05,p<0.05);positive biopsies were more frequently obtained in 37 of 83(44.5%)targeted cores compared to 112 of 810(13.8%)systematic cores,while on a per patient basis,the prostate cancer was more frequently detected by SB(30)compared to TB(29)in those 35 patients with prostate cancer.The diagnostic efficiency of CE-TRUS technology in PSA<10ng/ml patients(24.3%)compared to that in the PSA>10ng/ml patients(40.9%)had no significant difference(P>0.05).Conclusion:CEUS may detect more cases of prostate cancer than TRUS and the targeted biopsy of contrast-enhanced abnormalities or transrectal ultrasound provides a significant benefit for the detection of prostate cancer,but systematic biopsies should not be eliminated on the basis of many cancers missed by CEUS.