MP48-03 CONTRAST ENHANCED ULTRASOUND WITH PARAMETRIC MAPS FOR THE DETECTION OF PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening I1 Apr 2015MP48-03 CONTRAST ENHANCED ULTRASOUND WITH PARAMETRIC MAPS FOR THE DETECTION OF PROSTATE CANCER Arnoud Postema, Peter Frinking, Martijn Smeenge, Theo De Reijke, Jean De la Rosette, Francois Tranquart, and Hessel Wijkstra Arnoud PostemaArnoud Postema More articles by this author , Peter FrinkingPeter Frinking More articles by this author , Martijn SmeengeMartijn Smeenge More articles by this author , Theo De ReijkeTheo De Reijke More articles by this author , Jean De la RosetteJean De la Rosette More articles by this author , Francois TranquartFrancois Tranquart More articles by this author , and Hessel WijkstraHessel Wijkstra More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1677AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Reliable imaging is needed to improve prostate cancer(PCa) diagnostic pathways. The altered microvascularity of malignant tissue is targeted by dynamic contrast enhanced ultrasound (DCE-US). Parametric maps generated by software that extracts perfusion parameters from DCE-US recordings can aid interpretation, increasing accuracy and decreasing user-dependency. This study aims to investigate the value of DCE-US, the added value of parametric maps and their potential to reduce the number of negative biopsy cores. METHODS For 651 biopsy locations in 82 consecutive patients that underwent DCE-US imaging, we correlated DCE-US interpretation with and without parametric maps with biopsy results. We used SonoVue® (Bracco, Milan, Italy) as contrast agent and parametric imaging software developed by Bracco Suisse SA (Geneva, Switzerland). We performed a stringent analysis including all positive cores and a clinical analysis including only cores with ≥10% of Gleason ≥7. We determined the potential reduction in biopsies (negative on imaging) and resulting missed PCa (false negatives). We calculated sensitivity, specificty, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) on the per-patient level. RESULTS DCE-US alone classified 470/651 (72.2%) of the biopsies as benign. In the stringent analysis 71 (15.1%) of these were false negatives and in the clinical analysis 40(8.5%). Including parametric maps 411/651 (63.1%) biopsies were classified as benign. Assessed stringently 50 (12.1%) were false negative, clinically 23 (5.6%) were false negative. The clinical per-patient analysis produced our most interesting results: DCE-US classified 36/82 patients as not needing biopsies, missing 8 diagnoses. Including parametric maps, 29/82 patients were classified as benign resulting in 3 missed diagnoses. Sensitivity, specificty, PPV and NPV were 73%, 58%, 50% and 79% for DCE-US alone and 91% (p=0.0588), 56%, 57% and 90% with parametric maps. The figure shows a parametric map with the red zone indicating a high chance of PCa. The corresponding biopsy showed Gleason 3+4 PCa. CONCLUSIONS In our study of 651 biopsy locations a good prediction of biopsy outcome could be made using DCE-US with parametric maps. In our data almost two-thirds of the biopsy cores could be omitted with a modest decrease in PCa detection. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e595 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arnoud Postema More articles by this author Peter Frinking More articles by this author Martijn Smeenge More articles by this author Theo De Reijke More articles by this author Jean De la Rosette More articles by this author Francois Tranquart More articles by this author Hessel Wijkstra More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...