TRANSRECTAL ULTRASOUND MICROBUBBLE CONTRAST ANGIOGRAPHY OF THE PROSTATE

BACKGROUND. Prostate cancer, suspected by serum prostate-specific anti gen (PSA) elevation and/or digital abnormalities, is not always eviden t on gray-scale or color Doppler transrectal ultrasound (TRUS). EchoGe n(R) (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 empl oyed to see if it would improve prostate cancer detection, particularl y in patients with a rising serum PSA and prior negative biopsies. MET HODS. Color Doppler TRUS was performed before and after intravenous in jection of 0.05 ml/kg of EchoGen(R). Random and/or specifically direct ed sextant TRUS biopsies were performed. RESULTS. Fifteen patients wit h serum PSA elevations were included in the study. Fourteen had a nega tive 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 diagnose d with prostatitis. False-negative results were observed in 3 patients , whose positive biopsy sites were from the prostate apex. CONCLUSIONS . Following EchoGen(R) administration, prostate blood vessel image enh ancement was noted in all patients, and there were no adverse reaction s during or after EchoGen(R)administration with the dose employed. (C) 1997 Wiley-Liss, Inc.