Transrectal ultrasound microbubble contrast angiography of the prostate.

BACKGROUND

Prostate cancer, suspected by serum prostate-specific antigen (PSA) elevation and/or digital abnormalities, is not always evident on gray-scale or color Doppler transrectal ultrasound (TRUS). EchoGen (Sonus Pharmaceuticals, Inc., Bothell, WA), a blood vessel image enhancer able to visualize smaller, low-flow vessels and thus possibly the microvascular angiogenesis often associated with cancer, was employed to see if it would improve prostate cancer detection, particularly in patients with a rising serum PSA and prior negative biopsies.

METHODS

Color Doppler TRUS was performed before and after intravenous injection of 0.05 ml/kg of EchoGen. Random and/or specifically directed sextant TRUS biopsies were performed.

RESULTS

Fifteen patients with serum PSA elevations were included in the study. Fourteen had a negative prior biopsy (1-3 x). Prostate cancer was detected in 5 patients. Microvascular patterns were judged abnormal in 8 patients, 2 of which proved malignant, 2 of which were benign, and 1 of which was diagnosed with prostatis. False-negative results were observed in 3 patients, whose positive biopsy sites were from the prostate apex.

CONCLUSIONS

Following EchoGen administration, prostate blood vessel image enhancement was noted in all patients, and there were no adverse reactions during or after EchoGen administration with the dose employed.