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. 2011 Oct;29(5):581-7.
doi: 10.1007/s00345-011-0747-3. Epub 2011 Aug 17.

Novel contrast-enhanced ultrasound imaging in prostate cancer

Martijn Smeenge  1 , Massimo Mischi, M Pilar Laguna Pes, Jean J M C H de la Rosette, Hessel Wijkstra
Affiliations

Novel contrast-enhanced ultrasound imaging in prostate cancer

Martijn Smeenge et al. World J Urol. 2011 Oct.

Abstract

Purpose: The purposes of this paper were to present the current status of contrast-enhanced transrectal ultrasound imaging and to discuss the latest achievements and techniques now under preclinical testing.

Objective: Although grayscale transrectal ultrasound is the standard method for prostate imaging, it lacks accuracy in the detection and localization of prostate cancer. With the introduction of contrast-enhanced ultrasound (CEUS), perfusion imaging of the microvascularization became available. By this, cancer-induced neovascularisation can be visualized with the potential to improve ultrasound imaging for prostate cancer detection and localization significantly. For example, several studies have shown that CEUS-guided biopsies have the same or higher PCa detection rate compared with systematic biopsies with less biopsies needed.

Materials and methods: This paper describes the current status of CEUS and discusses novel quantification techniques that can improve the accuracy even further. Furthermore, quantification might decrease the user-dependency, opening the door to use in the routine clinical environment. A new generation of targeted microbubbles is now under pre-clinical testing and showed avidly binding to VEGFR-2, a receptor up-regulated in prostate cancer due to angiogenesis. The first publications regarding a targeted microbubble ready for human use will be discussed.

Conclusion: Ultrasound-assisted drug delivery gives rise to a whole new set of therapeutic options, also for prostate cancer. A major breakthrough in the future can be expected from the clinical use of targeted microbubbles for drug delivery for prostate cancer diagnosis as well as treatment.

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Figures

Fig. 1
Fig. 1
Power modulation CEUS imaging. Each panel: left contrast-only, right normal gray scale imaging. a 20 s after contrast injection. The contrast-only image shows an almost black picture, demonstrating optimal tissue suppression. b Start inflow of contrast 26 s after injection. c Peak enhancement 34 s after injection. d 107 s after injection
Fig. 2
Fig. 2
Quantification: parametric image of diffusion parameter. Blue low diffusion, red high diffusion value
See this image and copyright information in PMC

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