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Prostate ultrasound---for urologists only?
Abstract
The value of ultrasound (US) in the diagnosis of prostate cancer
has dramatically increased in the past decade. This is mainly
related to the increasing incidence of prostate cancer, the most
common cancer in men and one of the most important causes of
death from cancer in men. The value of conventional gray-scale
US for prostate cancer detection has been extensively
investigated, and has shown a low sensitivity and specificity.
Therefore conventional gray-scale US is mainly used by
urologists for guiding systematic prostate biopsies. With the
development of new US techniques, such as color and power
Doppler US, and the introduction of US contrast agents, the role
of US for prostate cancer detection has dramatically changed.
Advances in US techniques were introduced to further increase
the value of US contrast agents. Although most of these
developments in US techniques, which use the interaction of the
contrast agent with the transmitted US waves, are very sensitive
for the detection of microbubbles, they are mostly unexplored,
in particular for prostate applications. Early reports of
contrast-enhanced US investigations of blood flow of the
prostate have shown that contrast-enhanced US adds important
information to the conventional gray-scale US technique.
Furthermore, elastography or `strain imaging' seems to have
great potential in prostate cancer detection. Since these new
advances in US are very sophisticated and need a long learning
curve, radiologists, who are overall better trained with these
new US techniques, will play a more important role in prostate
cancer diagnosis. Current trends show that these new US
techniques may allow for targeted biopsies and therefore replace
the current `gold standard' for prostate cancer detection---the
systematic biopsy. Consequently the use of these new US
techniques for the detection and clinical staging of prostate
cancer is promising. However, future clinical trials will be
needed to determine if the promise of these new US advances of
the prostate evolves into clinical application.
Author
Ferdinand Frauscher, Johann Gradl and Leo Pallwein
Contact Details
Corresponding address: Ferdinand Frauscher, MD,
Department of Radiology II,
Medical University Innsbruck,
Anichstrasse 35, 6020 Innsbruck,
Austria
Reference
ICIS Cancer Imaging Volume 5 Special Issue A
DOI: 10.1102/1470-7330.2005.0041
Date Posted
24 November 2005
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