Flemming Forsberg PhD, Presenter: Nothing to Disclose

Ji-Wen Yu, Abstract Co-Author: Nothing to Disclose

Babita Kuruvilla, Abstract Co-Author: Nothing to Disclose

Ethan Joseph Halpern MD, Abstract Co-Author: Nothing to Disclose

To evaluate microvessel density (MVD) measurements and contrast enhanced transrectal ultrasound imaging (TRUS), using the US contrast agent Imagent® (IMCOR Pharmaceutical, San Diego, CA), in prostate cancer.

Thirteen men scheduled for TRUS guided prostate biopsies (random sextant biopsies and up to 4 additional contrast directed biopsies) were evaluated. TRUS was performed after infusion of Imagent (approximate dose 0.31 mg/{kg min}) in grayscale phase inversion harmonic imaging (PIHI), color Doppler imaging (CDI) and power Doppler imaging (PDI) modes using an Elegra scanner (Siemens Medical Systems, Issaquah, WA). The enhancement and the suspicion of cancer at each biopsy site were assessed prospectively on a 5-point scale. All biopsy specimens were assessed for cancer with standard H&E stain and for MVD with an endothelial cell marker stain (CD31). MVD was determined using an SMZ-10A microscope (magnification 100x; Nikon, Melville, NY) and Image-Pro Plus software (Media Cybernetics, Silver Spring, MD). The area under the receiver operating characteristic (ROC) curve for MVD was computed using histopathology as the gold standard. Linear regression was used to correlate MVD with enhancement and suspicion of cancer for all imaging modes.

Of the 121 biopsy specimens, 99 had sufficient tissue for MVD determination. Sixteen (16%) contained malignant prostate tissue. The area under the ROC curve for the diagnosis of prostate cancer with MVD was 0.77. There was a statistically significant difference between benign and malignant MVDs (mean and standard deviations: 30.6±26.29 and 67.3±78.22 vessels/mm², respectively; p=0.0009). MVD correlated significantly with PIHI enhancement (r=0.24; p=0.0166) but not with CDI and PDI enhancement (r0.17). The suspicion of cancer assessed with all 3 TRUS modes correlated significantly with MVD (r>0.33; p<0.0007).

MVD is greater in malignant than in normal prostate tissues. MVD correlates with the enhancement seen on grayscale PIHI TRUS demonstrating the angiogenic underpinnings of PIHI of prostate cancer. This work was supported in part by DAMD17-01-1-0061 and IMCOR Pharmaceutical, San Diego, CA.

F.F.: This work was supported in part by DAMD17-01-1-0061 and IMCOR Pharmaceutical, San Diego, CA

Forsberg, F, Yu, J, Kuruvilla, B, Halpern, E, Contrast-enhanced TRUS and Microvessel Density Correlates in Prostate Cancer.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4414400.html