Contrast-enhanced transrectal ultrasound for prediction of prostate cancer aggressiveness: The role of normal peripheral zone time-intensity curves

Abstract

To assess the role of time-intensity curves (TICs) of the normal peripheral zone (PZ) in the identification of biopsy-proven prostate nodules using contrast-enhanced transrectal ultrasound (CETRUS). This study included 132 patients with 134 prostate PZ nodules. Arrival time (AT), peak intensity (PI), mean transit time (MTT), area under the curve (AUC), time from peak to one half (TPH), wash in slope (WIS) and time to peak (TTP) were analyzed using multivariate linear logistic regression and receiver operating characteristic (ROC) curves to assess whether combining nodule TICs with normal PZ TICs improved the prediction of prostate cancer (PCa) aggressiveness. The PI, AUC (p < 0.001 for both), MTT and TPH (p = 0.011 and 0.040 respectively) values of the malignant nodules were significantly higher than those of the benign nodules. Incorporating the PI and AUC values (both, p < 0.001) of the normal PZ TIC, but not the MTT and TPH values (p = 0.076 and 0.159 respectively), significantly improved the AUC for prediction of malignancy (PI: 0.784–0.923; AUC: 0.758–0.891) and assessment of cancer aggressiveness (p < 0.001). Thus, all these findings indicate that incorporating normal PZ TICs with nodule TICs in CETRUS readings can improve the diagnostic accuracy for PCa and cancer aggressiveness assessment.

Contrast-enhanced transrectal ultrasound can reduce collection of unnecessary biopsies when diagnosing prostate cancer and is predictive of biochemical recurrence following a radical prostatectomy in patients with localized prostate cancer

“…Previous studies have shown that angiogenesis correlates with tumor recurrence following a radical prostatectomy [26][27][28]. Contrast-enhanced ultrasonography, which is useful for assessing microvessel density, has also been reported to have potential value in predicting the outcome of patients with prostate cancer [29,30]. Our study demonstrated that CETRUS scores may be a reliable predictor of biochemical recurrence following a radical prostatectomy in patients with localized prostate cancer.…”

Diagnostic Performance of Multiparametric Transrectal Ultrasound in Localized Prostate Cancer: A Comparative Study With Magnetic Resonance Imaging

“…Contrast-enhanced US can reflect tissue microvascular perfusion dynamically, which is a promising tool in the detection of PCa 22,23 and the prediction of the PCa risk. 24 In our study, we found that a combination of synchronous wash-in/out and equal enhancement on CEUS images with a homogeneous distribution indicated a benign lesion that differed from PCa.…”

Contrast‐Enhanced Transrectal Ultrasound for Follow‐up After Focal HIFU Ablation for Prostate Cancer

“…Contrast‐enhanced TRUS has been used for diagnosis of prostate cancer in treatment‐naïve prostate glands with encouraging early outcomes . However, reports of contrast‐enhanced TRUS for evaluation of the prostate after HIFU are limited.…”

“…15 Contrast-enhanced TRUS has been used for diagnosis of prostate cancer in treatment-naïve prostate glands with encouraging early outcomes. 4 However, reports of contrast-enhanced TRUS for evaluation of the prostate after HIFU are limited. One study evaluated contrast-enhanced TRUS after whole-gland HIFU ablation during a short follow-up period of 1.5 months.…”

“…Contrast-enhanced transrectal ultrasound (TRUS) uses intravenous microbubble ultrasound (US) contrast agents to assess benign and cancerous prostate tissue by evaluating prostatic perfusion. [2][3][4] Earlier preclinical studies demonstrated that contrast-enhanced TRUS could be used to guide and monitor ablation in a dog model. 5,6 Herein, we report an initial clinical experience of using contrast-enhanced TRUS for follow-up after focal HIFU for prostate cancer.…”