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20.02.2020 | Original Article

Contrast-enhanced ultrasound with dispersion analysis for the localization of prostate cancer: correlation with radical prostatectomy specimens

verfasst von: Arnoud W. Postema, Maudy C. W. Gayet, Ruud J. G. van Sloun, Rogier R. Wildeboer, Christophe K. Mannaerts, C. Dilara Savci-Heijink, Stefan G. Schalk, Amir Kajtazovic, Henk van der Poel, Peter F. A. Mulders, Harrie P. Beerlage, Massimo Mischi, Hessel Wijkstra

Erschienen in: World Journal of Urology | Ausgabe 11/2020

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Abstract

Purpose

To determine the value of two-dimensional (2D) contrast-enhanced ultrasound (CEUS) imaging and the additional value of contrast ultrasound dispersion imaging (CUDI) for the localization of clinically significant prostate cancer (csPCa).

Methods

In this multicentre study, subjects scheduled for a radical prostatectomy underwent 2D CEUS imaging preoperatively. CUDI maps were generated from the CEUS recordings. Both CEUS recordings and CUDI maps were scored on the likelihood of presenting csPCa (any Gleason ≥ 4 + 3 and Gleason 3 + 4 larger than 0.5 mL) by five observers and compared to radical prostatectomy histopathology. An automated three-dimensional (3D) fusion protocol was used to match imaging with histopathology. Receiver operator curve (ROC) analysis was performed per observer and imaging modality.

Results

133 of 216 (62%) patients were included in the final analysis. Average area under the ROC for all five readers for CEUS, CUDI and the combination was 0.78, 0.79 and 0.78, respectively. This yields a sensitivity and specificity of 81 and 64% for CEUS, 83 and 56% for CUDI and 83 and 55% for the combination. Interobserver agreement for CEUS, CUDI and the combination showed kappa values of 0.20, 0.18 and 0.18 respectively.

Conclusion

The sensitivity and specificity of 2D CEUS and CUDI for csPCa localization are moderate. Despite compressing CEUS in one image, CUDI showed a similar performance to 2D CEUS. With a sensitivity of 83% at cutoff point 3, it could become a useful imaging procedure, especially with 4D acquisition, improved quantification and combination with other US imaging techniques such as elastography.

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Titel: Contrast-enhanced ultrasound with dispersion analysis for the localization of prostate cancer: correlation with radical prostatectomy specimens
verfasst von: Arnoud W. Postema
Maudy C. W. Gayet
Ruud J. G. van Sloun
Rogier R. Wildeboer
Christophe K. Mannaerts
C. Dilara Savci-Heijink
Stefan G. Schalk
Amir Kajtazovic
Henk van der Poel
Peter F. A. Mulders
Harrie P. Beerlage
Massimo Mischi
Hessel Wijkstra
Publikationsdatum: 20.02.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 11/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03103-4

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Contrast-enhanced ultrasound with dispersion analysis for the localization of prostate cancer: correlation with radical prostatectomy specimens