A Controlled Trial Comparing The Detection Rate Of Real-time CEUS With Conventional Doppler Ultrasound Guided Transrectal Prostate Biopsy

Purpose:The aim of this study is to determine whether the use of real-time contrast-enhanced ultrasound-guided transrectal prostate biopsy can improve the detection rate of prostate cancer in the suspected patients in compared with the traditional standard ultrasound-guided transrectal prostate biopsy.Method:Between September 2017 and October 2019,100 patients who were suspected potential prostate cancer were enrolled in the study.They were all separated in real-time contrast-enhanced ultrasound-guided biopsy group?CEUS?or standard ultrasound-guided biopsy group?TRUS?randomly,and underwent combined real-time contrast-enhanced ultrasound-guided transrectal prostate targeted biopsy and standard biopsy or traditional ultrasound-guided transrectal prostate targeted biopsy and standard biopsy respectively.In the TRUS group,patients underwent TRUS-guided targeted biopsy and systematic 12-core prostate biopsy.In the CEUS group,patients underwent systematic 12-core prostate biopsy and 1 to 2 cores targeted prostate biopsy if suspected lesions were found in the CEUS scanning.The pathological tissues from systematic prostate biopsy were obtained by overlapping of conventional sextant,lateral base,mid-gland of peripheral zone and apex.Every tissue was marked and fixed individually,The outcome was the comparison of the detection rate between the CEUS group and the TRUS group.Result:Totally 100 patients were included in our study.In random,62 of them were separated into CEUS group and underwent combined real-time contrast-enhanced ultrasound-guided transrectal targeted biopsy and standard biopsy,3 8 of them were separated into TRUS group and underwent ultrasound-guided transrectal targeted biopsy and standard biopsy.19 cases of PCa were detected in CEUS group and 9 cases of PCa were detected in TRUS group,the CDR of PCa detection in CEUS group was obviously higher than in TRUS group?30.65%vs 23.68%,p<0.05?.Positive cores were found as number as 112 in CEUS group,with the percentage of positive core was 13.6%which was higher than in TRUS group?13.6%vs 11.3%?.Using CEUS as imaging device could detect more clinical significant PCa?csPCa?than normal ultrasound?22.6%vs 18.42%?.As univariate analysis,we found that using CEUS could yield higher PCa detection rate with prostate volume?PV?₅8.48cm3 or PSAD<0.22ng/?ml*cm3?.Using CEUS could also yield higher csPCa detection rate with a TPSA level between 4 to 10ng/ml or prostate volume?PV??58.48cm3 or PSAD<0.22ng/?ml*cm3?.Conclusion:In compared with normal ultrasound,using CEUS can yield a higher CDR of PCa,especially csPCa in transrectal prostate biopsy,the feasibility,safety,economic saving and time saving are the significant advantages.Thus,CEUS-guided transrectal prostate biopsy can be a better option in suspected prostate cancer detection.