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Keywords:

  • contrast enhanced ultrasound imaging;
  • prostate cancer;
  • hormonal treatment;
  • treatment follow-up

Abstract

BACKGROUND

We quantified changes in prostate carcinoma vascularity treated with anti-androgens using color Doppler and power transrectal ultrasound in combination with microbubble contrast agent Levovist®.

METHODS

Thirty-six men with prostate carcinoma were studied at baseline and at intervals during treatment. At each attendance, Levovist® (10 ml, 300 mg/ml) was given as an iv bolus. Using quantitative analysis, we calculated the pre-enhancement scores, arrival time, time to peak, peak value, and area under the time-enhancement curve (AUC). These were compared to pre-treatment values and serial PSA measurements.

RESULTS

The pre-enhancement, peak value, and AUC each showed a marked response with reductions within one week. The average AUC declined to 68% ± 9% (mean ± standard error) by week 1, 56% ± 9% by week 3, and 20% ± 4% by week 6. A strong correlation with changes in the mean PSA (r = 0.95, P < 0.001) was also measured. In four patients, Doppler indices did not fall with PSA: two patients with the most marked discrepancy relapsed at 6 months.

CONCLUSION

The vascular enhancement declined with therapy, similar to PSA. Microbubble enhanced ultrasound can show early response to treatment. Prostate 51: 256–267, 2002. © 2002 Wiley-Liss, Inc.