Article

Contrast-enhanced gray-scale transrectal ultrasound-guided prostate biopsy in men with elevated serum prostate-specific antigen levels.

Department of Ultrasound, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, PR China.
Academic radiology (impact factor: 2.09). 11/2008; 15(10):1291-7. DOI:10.1016/j.acra.2008.03.022 pp.1291-7
Source: PubMed

ABSTRACT Our goal was to evaluate the role of contrast-enhanced gray-scale transrectal ultrasound (CETRUS)-guided prostate biopsy in patients with elevated serum prostate-specific antigen (PSA) levels.
A total of 115 men (mean age, 70 years; range, 47-85) with serum PSA levels of greater than 4.0 ng/ml were assessed using gray-scale transrectal ultrasound (TRUS), power Doppler ultrasound (PDU), and CETRUS. Subsequently, these patients underwent systematic sextant transrectal biopsy and additional biopsies for positive sites on gray-scale TRUS, PDU, and CETRUS. The cancer detection rates of the three techniques were compared.
Cancer was detected in 63 of the 115 patients (55%). CETRUS was positive in 50 patients, 35 of whom (70%) had prostate cancer; CETRUS had a higher sensitivity, specificity, and accuracy of 65% (41/63), 83% (43/52), and 73% (84/115), respectively. CETRUS could have saved a significant number of patients from undergoing unnecessary biopsies, compared to TRUS and PDU. However, no significant correlation was found between the Gleason score and CETRUS grade.
The use of CETRUS in detecting prostate cancer might reduce the number of unnecessary needle biopsies of the prostate in patients with abnormally high serum PSA levels and increase the detection rate of clinically significant prostate cancer.

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Keywords

50 patients
 
additional biopsies
 
cancer detection rates
 
CETRUS grade
 
CETRUS)-guided prostate biopsy
 
clinically significant prostate cancer
 
contrast-enhanced gray-scale transrectal ultrasound
 
detecting prostate cancer
 
detection rate
 
Gleason score
 
gray-scale transrectal ultrasound
 
gray-scale TRUS
 
power Doppler ultrasound
 
serum prostate-specific antigen
 
serum PSA levels
 
significant correlation
 
significant number
 
three techniques
 
undergoing unnecessary biopsies
 
unnecessary needle biopsies