Contrast-enhanced transrectal ultrasound can reduce collection of unnecessary biopsies when diagnosing prostate cancer and is predictive of biochemical recurrence following a radical prostatectomy in patients with localized prostate cancer.

To investigate the value of using contrast-enhanced transrectal ultrasound (CETRUS) to reduce unnecessary collection of biopsies during prostate cancer diagnosis and its utility in predicting biochemical recurrence in patients with localized prostate cancer.

This was a prospective study of suspected prostate cancer patients who were evaluated with CETRUS followed by a prostate biopsy. Prostate blood flow via CETRUS was graded using a 5-point scale. The relationship between CETRUS score and biopsy outcome was then analyzed for all patients; univariate and multi-variate analyses were used to determine the probable prognostic factors for biochemical recurrence in patients with localized prostate cancer that underwent a radical prostatectomy.

A total of 347 patients were enrolled in the study. Prostate cancer was found in 164 patients. A significant positive correlation (r = 0.69, p < 0.001) was found between CETRUS scores and prostate cancer incidence. Using CETRUS scores ≥2 as the threshold for when to biopsy could have safely reduced the number of biopsies taken overall by 12.1% (42/347) and spared 23.0% (42/183) of patients from undergoing an unnecessary biopsy. 77 patients with localized prostate cancer underwent a radical prostatectomy. The median follow-up time was 30 months (range: 8-56 months) and 17 of these 77 patients exhibited biochemical recurrence during the follow-up period. 3-year biochemical recurrence-free survival rates were 86% for patients with low CETRUS scores (≤ 3) and 59% for patients with high scores (> 3; p = 0.015). Multivariate Cox regression analysis indicated that CETRUS score was an independent predictor of biochemical recurrence (HR: 7.02; 95% CI: 2.00-24.69; p = 0.002).

CETRUS scores may be a useful tool for reducing the collection unnecessary biopsy samples during prostate cancer diagnosis and are predictive of biochemical recurrence in patients with localized prostate cancer following a radical prostatectomy.

BMC urology. 2020 Jul 16*** epublish ***

Hong-Wei Zhao, Jian Li, Jia-Zheng Cao, Juan Lin, Zhu Wang, Jian-Yao Lv, Jin-Huan Wei, Zhen-Hua Chen, Hao-Hua Yao, Yi-Hui Pan, Zhen-Li Gao, Jun-Hang Luo, Wei Chen, Lei Shi, Yong Fang

Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, Shandong, P. R. China., State Key Laboratory of Oncology in South China, Department of Ultrasound, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China., Department of Urology, Jiangmen Hospital, Sun Yat-Sen University, Jiangmen, 529000, Guangdong, P. R. China., Department of Pediatrics, hird Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, P. R. China., Department of Ultrasound, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China., Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China., Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, Shandong, P. R. China. ., Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China. .