The value of contrast-enhanced transrectal ultrasound in predicting the nature of prostate diseases and the Gleason score of prostate cancer by a subjective blood flow grading scale

Urol Int. 2011;87(2):165-70. doi: 10.1159/000327988. Epub 2011 Aug 11.

Abstract

Objectives: To investigate the value of contrast-enhanced transrectal ultrasound (CETRUS) in predicting the nature of prostate diseases and prostate cancer Gleason score.

Methods: 106 patients suspected of prostate cancer were evaluated with CETRUS followed by systematic biopsy. Prostate blood flow of CETRUS was graded using a subjective 5-point scale. The relationships between ultrasound findings and biopsy outcomes, as well as prostate cancer Gleason score were analyzed. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of CETRUS.

Results: Biopsy revealed prostate cancer in 43 of 106 patients. The proportions of malignant histology in the groups with CETRUS scores of 1-5 were 0% (0/10), 8.3% (2/24), 31.7% (13/41), 88.9% (16/18) and 92.3% (12/13), respectively. The rate of prostate cancer with a Gleason score ≥7 in the groups with a CETRUS score of 2-5 were 0% (0/2), 15.4% (2/13), 37.5% (6/16) and 91.7% (11/12), respectively. The blood flow grading scale correlated with pathological outcomes and Gleason score significantly (r = 0.66, p < 0.001; and r = 0.61, p < 0.001, respectively). ROC analysis showed the area under the ROC curve to be 0.87.

Conclusions: CETRUS-based blood flow grading scale is a reliable tool for predicting the pathological outcome of prostate diseases and prostate cancer Gleason score noninvasively.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biopsy
  • Blood Flow Velocity
  • Contrast Media / pharmacology*
  • False Positive Reactions
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading / methods
  • Prostate / pathology
  • Prostatic Neoplasms / blood supply
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology*
  • ROC Curve
  • Treatment Outcome
  • Ultrasonics
  • Ultrasonography
  • Ultrasound, High-Intensity Focused, Transrectal / methods*

Substances

  • Contrast Media