Does the adjunct of ecographic contrast medium Levovist improve the detection rate of prostate cancer?

Abstract

OBJECTIVES:

To evaluate whether the adjunct of an ultrasound contrast medium improves the detection rate of prostate cancer.

METHOD:

In 34 patients, scheduled to undergo a trans-perineal extended prostate biopsy, we carried out a color-Doppler ultrasound (CDU) of the prostate before and after i.v. injection of Levovist, an ultrasound contrast medium. Further bioptic samples were taken in the areas where a marked increase in vascularization was noticed.

RESULTS:

The overall diagnostic sensitivity, specificity and efficiency were respectively 72.7, 56.2 and 62.9% for transrectal ultrasound (TRUS); 80, 56.2 and 65.3% for CDU and 88.8, 54.5 and 68% for CDU after Levovist injection; 66.5, 72.6 and 65.1% for digito-rectal examination (DRE); 100, 51.4 and 65.4% for total PSA; and 100, 88.8 and 94.3% for PSA free/total. In the 16 patients with prostate carcinoma, the sensitivity of CDU after Levovist was 92.3, 66% for both DRE and TRUS, and 80% for DRE plus TRUS.

CONCLUSIONS:

Considering the cost and the results obtained (high sensitivity and low specificity), a routine use of Levovist does not seem indicated in patients undergoing prostatic biopsy. An exception may be represented by patients with both negative DRE and TRUS.

• Authors: P Pepe, D Patanè, P Panella, F Aragona
• Journal: Prostate cancer and prostatic diseases (Prostate Cancer Prostatic Dis) Vol. 6 Issue 2 Pg. 159-62 ( 2003) ISSN: 1365-7852 [Print] England
• PMID: 12806376 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media
• Polysaccharides
• SHU 508
• Prostate-Specific Antigen

Topics

• Aged
• Biopsy
• Contrast Media
• Health Care Costs
• Humans
• Male
• Middle Aged
• Polysaccharides
• Predictive Value of Tests
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (diagnostic imaging)
• Rectum (diagnostic imaging)
• Sensitivity and Specificity
• Ultrasonography, Doppler, Color (economics, methods)