Skip to main content
SpringerLink
Log in

Ultrasound of prostate cancer: recent advances

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Prostate cancer is the most common cancer in men. In the future, a significant further increase in the incidence of prostate cancer is expected. Therefore, improvement of prostate cancer diagnosis is a main topic of diagnostic imaging. The systematic prostate biopsy (“ten-core biopsy”) is now the “gold standard” of prostate cancer diagnosis but may miss prostate cancer. Contrast-enhanced colour Doppler ultrasound (US) and elastography are evolving methods that may dramatically change the role of US for prostate cancer diagnosis. Contrast-enhanced colour Doppler US allows for investigations of the prostate blood flow and consequently for prostate cancer visualization and therefore for targeted biopsies. Comparisons between systematic and contrast-enhanced targeted biopsies have shown that the targeted approach detects more cancers and cancers with higher Gleason scores with a reduced number of biopsy cores. Furthermore, elastography, a new US technique for the assessment of tissue elasticity has been demonstrated to be useful for the detection of prostate cancer, and may further improve prostate cancer staging. Therefore, contrast-enhanced colour Doppler US and elastography may have the potential to improve prostate cancer detection, grading and staging. However, further clinical trials will be needed to determine the promise of these new US advances.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C et al (2006) Cancer statistics, 2006. CA Cancer J Clin 56(2):106–130

    Article  PubMed  Google Scholar 

  2. Smith RA, Cokkinides V, Eyre HJ (2006) American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin 56(1):11–25; quiz 49–50

    PubMed  Google Scholar 

  3. Gretzer MB, Partin AW (2003) PSA markers in prostate cancer detection. Urol Clin North Am 30(4):677–686

    Article  PubMed  Google Scholar 

  4. McNeal JE, Redwine EA, Freiha FS, Stamey TA (1988) Zonal distribution of prostatic adenocarcinoma. Correlation with histologic pattern and direction of spread. Am J Surg Pathol 12(12):897–906

    Article  PubMed  CAS  Google Scholar 

  5. Keetch DW, Catalona WJ, Smith DS (1994) Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values. J Urol 151(6):1571–1574

    PubMed  CAS  Google Scholar 

  6. Ellis WJ, Brawer MK (1995) Repeat prostate needle biopsy: who needs it? J Urol 153(5):1496–1498

    Article  PubMed  CAS  Google Scholar 

  7. Presti JC Jr, Chang JJ, Bhargava V, Shinohara K (2000) The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial. J Urol 163(1):163–166; discussion 166–167

    Article  PubMed  Google Scholar 

  8. Jones JS, Patel A, Schoenfield L, Rabets JC, Zippe CD, Magi-Galluzzi C (2006) Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J Urol 175(2):485–488

    Article  PubMed  Google Scholar 

  9. Kay PA, Robb RA, Bostwick DG (1998) Prostate cancer microvessels: a novel method for three dimensional reconstruction and analysis. Prostate 37(4):270–277

    Article  PubMed  CAS  Google Scholar 

  10. Louvar E, Littrup PJ, Goldstein A, Yu L, Sakr W, Grignon D (1998) Correlation of color Doppler flow in the prostate with tissue microvascularity. Cancer 83(1):135–140

    Article  PubMed  CAS  Google Scholar 

  11. Weidner N, Carroll PR, Flax J, Blumenfeld W, Folkman J (1993) Tumor angiogenesis correlates with metastasis in invasive prostate carcinoma. Am J Pathol 143(2):401–409

    PubMed  CAS  Google Scholar 

  12. Brawer MK (1996) Quantitative microvessel density. A staging and prognostic marker for human prostatic carcinoma. Cancer 78(2):345–349

    Article  PubMed  CAS  Google Scholar 

  13. Borre M, Offersen BV, Nerstrom B, Overgaard J (1998) Microvessel density predicts survival in prostate cancer patients subjected to watchful waiting. Br J Cancer 78(7):940–944

    PubMed  CAS  Google Scholar 

  14. Kedar RP, Cosgrove D, McCready VR, Bamber JC, Carter ER (1996) Microbubble contrast agent for color Doppler US: effect on breast masses. Work in progress. Radiology 198(3):679–686

    PubMed  CAS  Google Scholar 

  15. Forsberg F, Merton DA, Liu JB, Needleman L, Goldberg BB (1998) Clinical applications of ultrasound contrast agents. Ultrasonics 36(1–5):695–701

    Article  PubMed  CAS  Google Scholar 

  16. Forsberg F, Liu JB, Burns PN, Merton DA, Goldberg BB (1994) Artifacts in ultrasonic contrast agent studies. J Ultrasound Med 13(5):357–365

    PubMed  CAS  Google Scholar 

  17. Bree RL (1997) The role of color Doppler and staging biopsies in prostate cancer detection. Urology 49(3A Suppl):31–34

    Article  PubMed  CAS  Google Scholar 

  18. Frauscher F, Klauser A, Volgger H, Halpern EJ, Pallwein L, Steiner H et al (2002) Comparison of contrast enhanced color Doppler targeted biopsy with conventional systematic biopsy: impact on prostate cancer detection. J Urol 167(4):1648–1652

    Article  PubMed  Google Scholar 

  19. Pelzer A, Bektic J, Berger AP, Pallwein L, Halpern EJ, Horninger W et al (2005) Prostate cancer detection in men with prostate specific antigen 4 to 10 ng/ml using a combined approach of contrast enhanced color Doppler targeted and systematic biopsy. J Urol 173(6):1926–1929

    Article  PubMed  Google Scholar 

  20. Roy C, Buy X, Lang H, Saussine C, Jacqmin D (2003) Contrast enhanced color Doppler endorectal sonography of prostate: efficiency for detecting peripheral zone tumors and role for biopsy procedure. J Urol 170(1):69–72

    Article  PubMed  Google Scholar 

  21. Mitterberger M, Pinggera G, Horninger W, Bartsch G, Strasser H, Schaefer G et al (2007) Comparison of contrast-enhanced colour Doppler targeted biopsy to conventional systematic biopsy: impact on Gleason score. J Urol 178(2):464–468

    Article  PubMed  CAS  Google Scholar 

  22. Mitterberger M, Pinggera G, Horninger W, Strasser H, Halpern E, Pallwein L et al (2007) Dutasteride Prior to Contrast–Enhanced Colour Doppler Ultrasound Prostate Biopsy Increases Prostate Cancer Detection. Eur Urol, Feb 20 [Epub ahead of print]

  23. Bogers HA, Sedelaar JP, Beerlage HP, de la Rosette JJ, Debruyne FM, Wijkstra H et al (1999) Contrast-enhanced three-dimensional power Doppler angiography of the human prostate: correlation with biopsy outcome. Urology 54(1):97–104

    Article  PubMed  CAS  Google Scholar 

  24. Unal D, Sedelaar JP, Aarnink RG, van Leenders GJ, Wijkstra H, Debruyne FM et al (2000) Three-dimensional contrast-enhanced power Doppler ultrasonography and conventional examination methods: the value of diagnostic predictors of prostate cancer. BJU Int 86(1):58–64

    Article  PubMed  CAS  Google Scholar 

  25. Sedelaar JP, van Leenders GJ, Hulsbergen-van de Kaa CA, van der Poel HG, van der Laak JA, Debruyne FM et al (2001) Microvessel density: correlation between contrast ultrasonography and histology of prostate cancer. Eur Urol 40(3):285–293

    Article  PubMed  CAS  Google Scholar 

  26. Strohmeyer D, Frauscher F, Klauser A, Recheis W, Eibl G, Horninger W et al (2001) Contrast-enhanced transrectal color doppler ultrasonography (TRCDUS) for assessment of angiogenesis in prostate cancer. Anticancer Res 21(4B):2907–2913

    PubMed  CAS  Google Scholar 

  27. Halpern EJ, McCue PA, Aksnes AK, Hagen EK, Frauscher F, Gomella LG (2002) Contrast-enhanced US of the prostate with Sonazoid: comparison with whole-mount prostatectomy specimens in 12 patients. Radiology 222(2):361–366

    Article  PubMed  Google Scholar 

  28. Halpern EJ, Frauscher F, Rosenberg M, Gomella LG (2002) Directed biopsy during contrast-enhanced sonography of the prostate. AJR Am J Roentgenol 178(4):915–919

    PubMed  Google Scholar 

  29. Halpern EJ, Rosenberg M, Gomella LG (2001) Prostate cancer: contrast-enhanced us for detection. Radiology 219(1):219–225

    PubMed  CAS  Google Scholar 

  30. Halpern EJ, Ramey JR, Strup SE, Frauscher F, McCue P, Gomella LG (2005) Detection of prostate carcinoma with contrast-enhanced sonography using intermittent harmonic imaging. Cancer 104(11):2373–2383

    Article  PubMed  Google Scholar 

  31. Phillips P, Gardner E (2004) Contrast-agent detection and quantification. Eur Radiol 14(Suppl 8):P4–10

    Article  Google Scholar 

  32. Solbiati L, Tonolini M, Cova L (2004) Monitoring RF ablation. Eur Radiol 14(Suppl 8):P34–42

    Article  Google Scholar 

  33. Siosteen AK, Elvin A (2004) Intra-operative uses of contrast-enhanced ultrasound. Eur Radiol 14(Suppl 8):P87–95

    Article  Google Scholar 

  34. Huber S, Delorme S, Knopp MV, Junkermann H, Zuna I, von Fournier D et al (1994) Breast tumors: computer-assisted quantitative assessment with color Doppler US. Radiology 192(3):797–801

    PubMed  CAS  Google Scholar 

  35. Cosgrove DO, Bamber JC, Davey JB, McKinna JA, Sinnett HD (1990) Color Doppler signals from breast tumors. Work in progress. Radiology 176(1):175–180

    PubMed  CAS  Google Scholar 

  36. Huber S, Helbich T, Kettenbach J, Dock W, Zuna I, Delorme S (1998) Effects of a microbubble contrast agent on breast tumors: computer-assisted quantitative assessment with color Doppler US-early experience. Radiology 208(2):485–489

    PubMed  CAS  Google Scholar 

  37. Krouskop TA, Younes PS, Srinivasan S, Wheeler T, Ophir J (2003) Differences in the compressive stress-strain response of infiltrating ductal carcinomas with and without lobular features-implications for mammography and elastography. Ultrason Imaging 25(3):162–170

    PubMed  Google Scholar 

  38. Ophir J, Cespedes I, Ponnekanti H, Yazdi Y, Li X (1991) Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 13(2):111–134

    Article  PubMed  CAS  Google Scholar 

  39. Pesavento A, Lorenz A, Siebers S, Ermert H (2000) New real-time strain imaging concepts using diagnostic ultrasound. Phys Med Biol 45(6):1423–1435

    Article  PubMed  CAS  Google Scholar 

  40. Giuseppetti GM, Martegani A, Di Cioccio B, Baldassarre S (2005) Elastosonography in the diagnosis of the nodular breast lesions: preliminary report. Radiol Med (Torino) 110(1–2):69–76

    Google Scholar 

  41. Lyshchik A, Higashi T, Asato R, Tanaka S, Ito J, Mai JJ et al (2005) Thyroid gland tumor diagnosis at US elastography. Radiology 237(1):202–211

    Article  PubMed  Google Scholar 

  42. Cochlin DL, Ganatra RH, Griffiths DF (2002) Elastography in the detection of prostatic cancer. Clin Radiol 57(11):1014–1020

    Article  PubMed  Google Scholar 

  43. Sperandeo G, Sperandeo M, Morcaldi M, Caturelli E, Dimitri L, Camagna A (2003) Transrectal ultrasonography for the early diagnosis of adenocarcinoma of the prostate: a new maneuver designed to improve the differentiation of malignant and benign lesions. J Urol 169(2):607–610

    Article  PubMed  Google Scholar 

  44. Pallwein L, Mitterberger M, Struve P, Strasser H, Horninger W, Bartsch G et al (2007) Real-time elastography for detecting prostate cancer: preliminary experience. BJU Int 100(1):42–46

    Google Scholar 

  45. Konig K, Scheipers U, Pesavento A, Lorenz A, Ermert H, Senge T (2005) Initial experiences with real-time elastography guided biopsies of the prostate. J Urol 174(1):115–157

    Article  PubMed  Google Scholar 

  46. Pallwein L, Mitterberger M, Struve P, Horninger W, Aigner F, Bartsch G et al (2007) Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection. Eur Radiol 17(9):2278–2285

    Google Scholar 

  47. Pallwein E, Pallwein L, Aigner F, Fischbach V, zur Nedden D, Frauscher F (2007) Sonoelastography of the prostate: comparison with systematic biopsy findings in 492 patients. Eur Radiol 17(Suppl 1B):675

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Leo Pallwein, Friedrich Aigner, Johann Gradl, Dieter zur Nedden & Ferdinand Frauscher

  2. Department of Urology, Medical University of Innsbruck, Innsbruck, Austria

    Michael Mitterberger, Alexandre Pelzer, Georg Bartsch, Hannes Strasser & Germar M. Pinggera

Authors
  1. Leo Pallwein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Mitterberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexandre Pelzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Georg Bartsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hannes Strasser
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Germar M. Pinggera
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Friedrich Aigner
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Johann Gradl
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Dieter zur Nedden
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ferdinand Frauscher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leo Pallwein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pallwein, L., Mitterberger, M., Pelzer, A. et al. Ultrasound of prostate cancer: recent advances. Eur Radiol 18, 707–715 (2008). https://doi.org/10.1007/s00330-007-0779-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-007-0779-7

Keywords

Search

Navigation