2063: Contrast-enhanced US for prostate cancer detection in patients with a PSA level in the gray zone (4 to 10 Ng/ml) and negative digital rectal examination

Abstract

Objectives: To evaluate the usefulness of contrast-enhanced ultrasonography for prostate cancer detection in patients with a prostate-specific-antigen level in the gray zone (4 to 10 ng/ml) and negative digital rectal examination. Methods: Forty-eight patients underwent gray-scale, color Doppler and contrast-enhanced ultrasonography examinations and then ultrasonography-guided biopsy. Contrast-enhanced ultrasonography was obtained with use of Levovist at a mechanical index of 1.1 to 1.4. The performance of the three methods in cancer detection was compared according to biopsy site and patient. Results: Ultrasonography results were concordant with biopsy results at 296 (77%) of 384 sites on gray-scale, at 305 (79%) sites on color Doppler and at 312 (81%) sites on contrast-enhanced ultrasonography. The sensitivity according to biopsy site was greater on contrast-enhanced ultrasonography (68%) than on gray-scale (39%) and color Doppler (41%) ultrasonography (p < 0.05), whereas the specificity according to biopsy site and the sensitivity and specificity according to patient were not different in the three methods (p > 0.05). The agreement score between ultrasonography and biopsy results was not different in gray-scale (6.4 ± 1.8), color Doppler (6.3 ± 0.6) and contrast-enhanced ultrasonography (6.5 ± 0.7) (p = 0.281). Conclusions: Contrast-enhanced ultrasonography can improve the sensitivity over gray-scale and color Doppler ultrasonography in biopsy site-based analysis but cannot improve performance in patient-based analysis.