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Ultrasound Touted For Prostate Diagnosis

December 9, 2010
Written by: , Filed in: Diagnostic Imaging, Interventional Radiology
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Dutch researchers say they’ve developed an ultrasound-based imaging technology that can accurately identify prostate tumors and potentially could also assess their aggressiveness.

The key is injection of microbubbles of a contrast agent. The bubbles can enter even the smallest blood vessels.

The pattern of blood vessels in tumors differs from that in healthy tissue. So the researchers say they not only can find cancer this way, but they also may be able to evaluate the tumor’s aggressiveness by examining the blood-vessel patterns.

Researchers at Eindhoven University of Technology in Eindhoven, Netherlands, teamed with colleagues at Academic Medical Center Amsterdam, the hospital of the University of Amsterdam, to create the technique, known as contrast-enhanced ultrasound (CEUS). They describe it in a university news release via AlphaGalileo. And they discussed it at the recent 25th Annual Advances in Contrast Ultrasound-ICUS Bubble Conference in Chicago. (Several ultrasound companies are also involved in the research.)

The National Cancer Institute estimates that the United States this year will see 217,730 new cases of prostate cancer and 32,050 deaths from the disease. Diagnosis can still be very hit-and-miss. Typically, if the PSA level in the blood is elevated, biopsies are performed. However, many biopsies turn out to be unnecessary, and some yield a false negative, missing tumors because the biopsies are not targeted but instead randomly sample prostate tissue.

And sometimes doctors remove a tumor but discover it was so small and slow-growing that the patient would have been better off electing “watchful waiting” instead of surgery.

Massimo Mischi, PhD, of the Eindhoven University of Technology’s department of electrical engineering, said at the Chicago conference:

We know that as many as 76 percent of biopsies were in retrospect unnecessary. Effective diagnostic imaging is essential because localized therapies can be effective.

So far, the technology has been tested on only four patients who had their prostates removed. Dr. Mischi said the locations and sizes of the tumors accurately matched the CEUS images.

Next, the researchers plan a pilot program involving targeted biopsies guided by CEUS images. After that would come studies using the technology to determine whether biopsies are required. The ultimate goal is to rely on CEUS alone, without biopsies, for diagnosis and staging.

Related seminar: Diagnostic Imaging Review: For Residents, Fellows and Radiologists

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