Does the adjunct of ecographic contrast medium Levovist® improve the detection rate of prostate cancer?

Objectives: To evaluate whether the adjunct of an ultrasound contrast medium improves the detection rate of prostate cancer.Method: In 34 patients, scheduled to undergo a trans-perineal extended prostate biopsy, we carried out a color-Doppler ultrasound (CDU) of the prostate before and after i.v. injection of Levovist®, an ultrasound contrast medium. Further bioptic samples were taken in the areas where a marked increase in vascularization was noticed.Results: The overall diagnostic sensitivity, specificity and efficiency were respectively 72.7, 56.2 and 62.9% for transrectal ultrasound (TRUS); 80, 56.2 and 65.3% for CDU and 88.8, 54.5 and 68% for CDU after Levovist® injection; 66.5, 72.6 and 65.1% for digito-rectal examination (DRE); 100, 51.4 and 65.4% for total PSA; and 100, 88.8 and 94.3% for PSA free/total. In the 16 patients with prostate carcinoma, the sensitivity of CDU after Levovist® was 92.3, 66% for both DRE and TRUS, and 80% for DRE plus TRUS.Conclusions: Considering the cost and the results obtained (high sensitivity and low specificity), a routine use of Levovist® does not seem indicated in patients undergoing prostatic biopsy. An exception may be represented by patients with both negative DRE and TRUS.Prostate Cancer and Prostatic Diseases (2003) 6, 159-162. doi:10.1038/sj.pcan.4500647 [ABSTRACT FROM AUTHOR]