Microvessel density: Correlation between contrast ultrasonography and histology of prostate cancer

Objective: Increased microvessel density (MVD) of prostate cancer seems to be associated with poor prognosis and higher stage. Assessment of MVD using noninvasive methods could be of use in the work-up of patients with prosta te cancer. The aim of the present study was to correlate three-dimensional contrast-enhanced power Doppler ultrasound (3D-CE-PDU) findings with MVD ch aracteristics of radical prostatectomy specimens. Methods: Seven patients with biopsy-proven prostate cancer had 3D-CE-PDU in vestigations 2-3 weeks after prostate biopsies were taken and prior to radi cal prostatectomy. The investigations were performed using Levovist (R) con trast agent (Schering AG, Berlin, Germany) in combination with a Voluson 53 0D (R) ultrasound scanner (Kretz AG, Zipf, Austria). The 7 patients were se lected because of lateralization of the contrast enhancement. Histology sli des were made of the side with 'contrast enhancement' and of the contralate ral 'unenhanced' side and stained according to the catalyzed reporter depos ition (CARD) amplification procedure, and MVD parameters were obtained. Results: In all patients the MVD count of the 'enhanced' side was higher th an the MVD count of the 'unenhanced' side, averaging 1.93 times higher. On histology all enhanced lesions proved to contain prostate cancer tissue (av erage maximum diameter 25 mm (range 17-31)). Two patients had a small bilat eral tumor lesion (4 and 5 mm respectively) and in total 5 patients had eve n smaller satellite lesions (1-2 mm). The smaller lesions were not identifi ed using 3D-CE-PDU. Conclusions:The present study shows that 3D power Doppl er contrast ultrasonography is a minimally invasive imaging modality, which has the potential to visualize lesions with increased MVD. This property o f 3D-CE-PDU could be used in the detection of prostate cancer. Copyright (C ) 2001 S. Karger AG, Basel.