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Comparison of contrast-enhanced ultrasound targeted biopsy versus standard systematic biopsy for clinically significant prostate cancer detection: results of a prospective cohort study with 1024 patients

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Abstract

Purpose

To assess contrast-enhanced ultrasound (CEUS) targeted biopsy (TB) for clinically significant prostate cancer (PCa) detection compared with systematic biopsy (SB).

Methods

A total of 1024 consecutive patients scheduled for prostate biopsy were enrolled in this prospective study. CEUS was performed by an experienced radiologist blinded to all clinical data. Suspicious lesions on postcontrast images were sampled in addition to standard 12-core SB. The clinically significant PCa detection rate by CEUS-TB was evaluated in comparison with SB in the total cohort and in different subgroups.

Results

In 378 of 1024 patients (36.9%), the diagnosis of PCa was histologically confirmed. PCa was detected by CEUS-TB in 306 patients (29.9%, 306/1024) and SB in 317 patients (31.0%, 317/1024, P = 0.340). Among 378 PCa patients, 326 (86.2%, 326/378) were diagnosed with significant PCa using Epstein criteria. The significant PCa detection rate of CEUS-TB was 28.7% (294/1024), which was higher than that of SB (25.3%, 259/1024, P = 0.000). CEUS-TB resulted in 67 additional cases of clinically significant PCa, including 51 patients missed by SB and 16 patients under-graded by SB. Conversely, SB detected 32 additional significant PCa missed by TB. In the subgroup analysis, CEUS-TB yielded a higher significant cancer detection rate than SB in patients with a PSA level ≤ 10.0 ng/ml or prostate volume from 30 to 60 ml.

Conclusion

The clinically significant PCa detection rate could be improved by the extra sampling of abnormalities on postcontrast images, especially in patients with a PSA level ≤ 10.0 ng/ml or prostate volume from 30 to 60 ml.

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Funding

This work was supported by a grant from the National Natural Science Foundation of China (no. 81671708), the Science and Technology Commission of Shanghai Municipality (no. 15411961000), the Shanghai Shen Kang Hospital Development Center Research Project (no. 16CR3092B) and the Fund of Shanghai Jiaotong University (no. YG2014ZD04).

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Authors and Affiliations

  1. Department of Ultrasound in Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Zhu Yunkai, Chen Yaqing, Jiang Jun, Qi Tingyue, Liu Weiyong & Qu Yuehong

  2. Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Guan Wenbin & Wang Lifeng

  3. Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Qi Jun

Authors
  1. Zhu Yunkai
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  2. Chen Yaqing
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  3. Jiang Jun
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  4. Qi Tingyue
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  5. Liu Weiyong
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  6. Qu Yuehong
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  7. Guan Wenbin
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  8. Wang Lifeng
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  9. Qi Jun
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Contributions

ZY: data collection and management, data analysis, manuscript writing. CY: project development, manuscript editing. JJ: data collection, data analysis, manuscript editing. QT: data collection, data analysis. LW: data collection. QY: data collection. GW: data collection. WL: data collection. QJ: project development, data collection.

Corresponding author

Correspondence to Chen Yaqing.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yunkai, Z., Yaqing, C., Jun, J. et al. Comparison of contrast-enhanced ultrasound targeted biopsy versus standard systematic biopsy for clinically significant prostate cancer detection: results of a prospective cohort study with 1024 patients. World J Urol 37, 805–811 (2019). https://doi.org/10.1007/s00345-018-2441-1

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  • DOI: https://doi.org/10.1007/s00345-018-2441-1

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