Results of Vardenafil Mediated Power Doppler Ultrasound, Contrast Enhanced Ultrasound and Systematic Random Biopsies to Detect Prostate Cancer

Morelli, Girolamo; Pagni, R; Mariani, Chiara; Minervini, R.; Morelli, Andrea; Gori, Francesco; Ferdeghini, E.M.; Paterni, Marco; Mauro, Eva; Guidi, Elisa; Armillotta, Nicola; Canale, Domenico; Vitti, Paolo; Caramella, Davide; Minervini, Andrea

doi:10.1016/j.juro.2011.02.014

Cited by 24 publications

(13 citation statements)

References 21 publications

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“…Enhanced ultrasound techniques including color and power Doppler have been used in an attempt to enhance prostate cancer detection over conventional TRUS (LoTRUS). However, despite modest improvements over LoTRUS these modalities are not in widespread clinical use despite availability [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

High-resolution transrectal ultrasound: Pilot study of a novel technique for imaging clinically localized prostate cancer

Pavlovich

Cornish

Mullins

et al. 2014

Urologic Oncology: Seminars and Original Investigations

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Methods and materials: Twenty-five men with known prostate cancer scheduled for radical prostatectomy were preoperatively imaged with both LoTRUS (5 MHz) and HiTRUS (21 MHz). Dynamic cine loops and still images for each modality were saved and subjected to blinded review by a radiologist looking for hypoechoic foci ~5 mm in each sextant of the prostate. Following prostatectomy, areas of prostate cancer ~ 5 mm on pathologic review were anatomically correlated to LoTRUS and HiTRUS findings. The accuracy of LoTRUS and HiTRUS to visualize prostate cancer in each sextant of the prostate and to identify high-grade and locally advanced disease was assessed. The McNemar test was used to compare sensitivity and specificity and paired dichotomous outcomes between imaging modalities.Results: Among 69 sextants with pathologically identified cancerous foci at radical prostatecomy, HiTRUS visualized 45 and missed 24, whereas LoTRUS visualized 26 and missed 43. Compared with LoTRUS, HiTRUS demonstrated improved sensitivity (65.2% vs. 37.7%) and specificity (71.6% vs. 65.4%). HiTRUS's agreement with pathologic findings was twice as high as LoTRUS (P = 0.006). HiTRUS provided a nonsignificant increase in visualization of high-grade lesions (84% vs. 60%, P = 0.11).Conclusions: HiTRUS appears promising for prostate cancer imaging. Our initial experience suggests superiority to LoTRUS for the visualization of cancerous foci, and supports proceeding with a clinical trial in the biopsy setting.

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Section: Introductionmentioning

confidence: 99%

High-resolution transrectal ultrasound: Pilot study of a novel technique for imaging clinically localized prostate cancer

Pavlovich

Cornish

Mullins

et al. 2014

Urologic Oncology: Seminars and Original Investigations

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“…Tadalafil suppressed the decrease in bladder blood flow and impairment of bladder function in a rat partial bladder outlet obstruction model . In humans also, a single administration of PDE5 inhibitors, sildenafil, valdenafil and tadalafil, significantly increased prostate blood flow detected by power Doppler ultrasound in patients with BPH, patients with prostate‐specific antigen level of >4 ng/mL and healthy individuals . Zaparinst, a PDE5 inhibitor, enhanced NO‐induced vasodilation in isolated rat aortic rings, pulmonary circulation of intact lambs and cats with experimental pulmonary hypertension, and in cats’ hindlimb circulation .…”

Section: Pde5 and Vascular Functionmentioning

confidence: 96%

Lower urinary tract symptoms/benign prostatic hypertrophy and vascular function: Role of the nitric oxide–phosphodiesterase type 5–cyclic guanosine 3′,5′‐monophosphate pathway

Higashi

2017

Int J of Urology

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It is well known that there is an association of lower urinary tract symptoms/ benign prostatic hypertrophy with cardiovascular disease, suggesting that lower urinary tract symptoms/benign prostatic hypertrophy is a risk factor for cardiovascular events. Vascular function, including endothelial function and vascular smooth muscle function, is involved in the pathogenesis, maintenance and development of atherosclerosis, leading to cardiovascular events. Vascular dysfunction per se should also contribute to lower urinary tract symptoms/benign prostatic hypertrophy. Both lower urinary tract symptoms/benign prostatic hypertrophy and vascular dysfunction have cardiovascular risk factors, such as hypertension, dyslipidemia, diabetes mellitus, aging, obesity and smoking. Inactivation of the phosphodiesterase type 5-cyclic guanosine 3 0 ,5 0 -monophosphate-nitric oxide pathway causes lower urinary tract symptoms/benign prostatic hypertrophy through an enhancement of sympathetic nervous activity, endothelial dysfunction, increase in Rho-associated kinase activity and vasoconstriction, and decrease in blood flow of pelvic viscera. Both endogenous nitric oxide and exogenous nitric oxide act as vasodilators on vascular smooth muscle cells through an increase in the content of cyclic guanosine 3 0 ,5 0 -monophosphate, which is inactivated by phosphodiesterase type 5. In a clinical setting, phosphodiesterase type 5 inhibitors are widely used in patients with lower urinary tract symptoms/benign prostatic hypertrophy. Phosphodiesterase type 5 inhibitors might have beneficial effects on vascular function through not only inhibition of cyclic guanosine 3 0 ,5 0 -monophosphate degradation, but also increases in testosterone levels and nitric oxide bioavailability, increase in the number and improvement of the function of endothelial progenitor cells, and decrease in insulin resistance. In the present review, the relationships between lower urinary tract symptoms/benign prostatic hypertrophy, the phosphodiesterase type 5-nitric oxidecyclic guanosine 3 0 ,5 0 -monophosphate pathway, vascular function and cardiovascular outcomes are examined.Key words: benign prostatic hypertrophy, lower urinary tract symptoms, nitric oxide, phosphodiesterase type 5-cyclic guanosine 3 0 ,5 0 -monophosphate, vascular function.

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“…[26] This finding was consistent with the results of several TRUS biopsy controlled studies with reported CEUS sensitivity ranging from 65–93%. [22–24;27] In his phase I FT trial of 12 patients using a diode laser as the ablative energy source, Lindner et al creatively employed CEUS to monitor ablative areas, which appeared as well-defined regions of decreased enhancement. Post-treatment MRI confirmed good overlap of necrotic areas with intraoperative CEUS findings.…”

Section: Ultrasound Guidance In Focal Therapy Of Prostate Cancermentioning

confidence: 99%

Image guidance in the focal treatment of prostate cancer

Hoang

Volkin

Yerram

et al. 2012

Current Opinion in Urology

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Purpose of Review The advent of PSA screening has led to a 7-fold increase in the incidence of prostate cancer (PCa) without a resultant decrease in mortality rate. This has led to the belief that urologists are over-detecting and over-treating the clinically insignificant disease. To maintain the delicate balance between high cancer cure rate and overtreatment, which could potentially lead to unnecessary morbidities, focal therapy (FT) has emerged as the reasonable “middle ground.” In this article, we present the conceptual basis and the challenges of FT, while emphasizing the critical role of imaging in focal treatment of prostate cancer. Recent Findings Multiple phase I trials have demonstrated the feasibility, short-term efficacy, and safety of FT. Fundamental to the success of these trials and the ultimate acceptance of FT is the integral role of imaging in optimal patient selection. Among the different imaging modalities, only ultrasound and multiparametric MRI (mpMRI) are intimately involved in the detection, diagnosis, staging, and treatment of PCa. Each modality has its own unique advantages and shortcomings. Recent advances in enhanced ultrasound modalities (EUSMs), functional MRIs, and biopsy platforms have taken FT one step closer to becoming the standard of care. Summary Although early results of phase I FT trials are encouraging, long-term oncological outcomes remain to be elucidated. Incorporation of these technological advances into large prospective trials is needed to establish FT as an important asset in the urologist’s armamentarium against prostate cancer.

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Results of Vardenafil Mediated Power Doppler Ultrasound, Contrast Enhanced Ultrasound and Systematic Random Biopsies to Detect Prostate Cancer

Abstract: Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique.

Cited by 24 publications

References 21 publications

High-resolution transrectal ultrasound: Pilot study of a novel technique for imaging clinically localized prostate cancer

High-resolution transrectal ultrasound: Pilot study of a novel technique for imaging clinically localized prostate cancer

Lower urinary tract symptoms/benign prostatic hypertrophy and vascular function: Role of the nitric oxide–phosphodiesterase type 5–cyclic guanosine 3′,5′‐monophosphate pathway

Image guidance in the focal treatment of prostate cancer

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