Initial Experience with Contrast-Enhanced Sonography of the Prostate
Ethan J. Halpern1,
Lev Verkh2,
Flemming Forsberg1,
Leonard G. Gomella3,
Robert F. Mattrey4 and
Barry B. Goldberg1
1
Department of Radiology, Jefferson Prostate Center, Thomas Jefferson
University, 132 S. 10th St., Philadelphia, PA 19107-5244.
2
Alliance Pharmaceutical Corp., 3040 Science Park Rd., San Diego, CA
92121.
3
Department of Urology, Jefferson Prostate Center, Thomas Jefferson University,
Philadelphia, PA 19107-5244.
4
Department of Radiology, University of California at San Diego, 200 N. Arbor
Dr., San Diego, CA 92103.
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Fig. 1A. —77-year-old man with cancer (Gleason score, 6) in right base and mid
gland (prostate-specific antigen, 5.5 ng/ml). Transverse power Doppler
sonogram at baseline shows hypoechoic region in right base (short
arrows) associated with minimal flow (long arrow).
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Fig. 1B. —77-year-old man with cancer (Gleason score, 6) in right base and mid
gland (prostate-specific antigen, 5.5 ng/ml). Contrast-enhanced power Doppler
sonogram shows enhancement of periprostatic vessels and vessels in prostatic
parenchyma at right base (arrows). Enhancement at right base was not
prospectively appreciated. Power gain was reduced from 68 to 30 dB to
eliminate blooming.
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Fig. 2A. —61-year-old man with cancer (Gleason score, 6) along left side of
prostate from base to apex (prostate-specific antigen, 9.1 ng/ml). Transverse
sonographic image at baseline reveals homogeneous echotexture pattern.
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Fig. 2B. —61-year-old man with cancer (Gleason score, 6) along left side of
prostate from base to apex (prostate-specific antigen, 9.1 ng/ml).
Contrast-enhanced intermittent image with 2-sec interscan delay shows focal
enhancement at site of cancer in left base (arrows).
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Fig. 3A. —61-year-old man with cancer (Gleason score, 9) along left side of
prostate from base to apex (prostate-specific antigen, 10.4 ng/ml). Transverse
sonographic image at baseline reveals no focal lesion.
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Fig. 3B. —61-year-old man with cancer (Gleason score, 9) along left side of
prostate from base to apex (prostate-specific antigen, 10.4 ng/ml).
Contrast-enhanced intermittent image with 2-sec interscan delay shows focal
enhancement at site of cancer in left mid gland (arrows).
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Fig. 3C. —61-year-old man with cancer (Gleason score, 9) along left side of
prostate from base to apex (prostate-specific antigen, 10.4 ng/ml).
Contrast-enhanced continuous image (obtained 20 sec after B) reveals no
focal enhancement.
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Fig. 3D. —61-year-old man with cancer (Gleason score, 9) along left side of
prostate from base to apex (prostate-specific antigen, 10.4 ng/ml).
Contrast-enhanced intermittent image with 4-sec interscan delay (obtained 18
sec after C) reveals diffuse enhancement and no evidence of a focal
enhancing cancer.
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Fig. 4A. —62-year-old man with visible bleeding after prostatic biopsy.
Transverse sonographic image of prostate before needle biopsy.
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Fig. 4B. —62-year-old man with visible bleeding after prostatic biopsy.
Transverse sonographic image shows biopsy needle along lateral margin of right
mid gland.
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Fig. 4C. —62-year-old man with visible bleeding after prostatic biopsy.
Transverse sonographic image obtained 30 sec after biopsy reveals enhancement
along biopsy tract.
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Fig. 4D. —62-year-old man with visible bleeding after prostatic biopsy.
Transverse sonographic image obtained 90 sec after biopsy reveals continued
enhancement along biopsy tract. Enhancement persisted for several minutes.
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Fig. 5A. —73-year-old man with marked benign prostatic hyperplasia
(prostate-specific antigen, 14.8 ng/ml). Contrast-enhanced intermittent image
obtained during contrast material infusion using a 2-sec interscan delay
reveals faint enhancement of inner gland (arrows).
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Fig. 5B. —73-year-old man with marked benign prostatic hyperplasia
(prostate-specific antigen, 14.8 ng/ml). Phase inversion image reveals
enhancement of inner gland (arrows) brighter than that seen in
A.
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