Monitoring blood flow helps improve prostate biopsies, researchers report

May 24, 2008

Using a special ultrasound technique to spot areas of blood flow in the prostate gland may substantially reduce the number of unnecessary biopsies, according to a new study by urologists and radiologists at the Jefferson Prostate Diagnostic Center and the Kimmel Cancer Center at Jefferson in Philadelphia. The researchers found that biopsies targeted to areas of increased blood flow in the prostate were twice as likely to be positive for cancer compared with conventional prostate biopsy techniques. They reported their initial results from a clinical trial this week at the annual meeting of the American Urological Association in Orlando.

According to Prostate Diagnostic Center co-director Edouard Trabulsi, M.D., assistant professor of Urology at Jefferson Medical College of Thomas Jefferson University, finding the best areas to perform biopsies in the prostate has always been difficult. Standard methods entail simply dividing the prostate into a dozen regions within the gland, almost randomly. Center co-director Ethan Halpern, M.D., who is principal investigator on the four-year, National Cancer Institute-supported trial, has been developing and refining techniques to enhance targeted biopsy of the prostate for more than a decade.

Dr. Trabulsi, Ethan Halpern, M.D., professor of Radiology and Urology at Jefferson Medical College, and their co-workers randomly divided 63 prostate biopsy patients into two groups. One group was given the drug dutasteride, which can reduce the blood flow in benign prostate tissue, while the other half received a placebo. They then compared the results from biopsies targeted by blood flow changes using contrast-enhanced ultrasound to those that were done the standard way. The study involved 979 biopsies.

“We’ve previously shown that a two-week course of the drug Avodart (dutasteride) before biopsy reduces the benign blood flow, or background noise,” Dr. Trabulsi explains, “allowing us to see subtle flow changes to target for biopsy. When we did this, we found that targeted biopsies based on the contrast-enhanced ultrasound are much more likely to detect prostate cancer. That’s the exciting part about this.”

Dr. Halpern explains that standard procedures fail to diagnose prostate cancer in approximately 30 percent of men with the disease, even though the biopsy protocol may sample 12 to 18 tissue cores from the prostate. “In the future, our goal is to perform a limited number of targeted biopsies and leave the rest of the prostate alone,” he says. “This will provide a safer, more cost-effective approach to diagnosing prostate cancer.”

The doctors say that the current study involves a novel ultrasound algorithm called flash replenishment imaging to show fine vascular flow differences. “The novelty is using the dutasteride before biopsy, using contrast-enhanced ultrasound and using the latest ultrasound technology to look for blood flow changes associated with prostate cancer.”

“We are beginning to have patients who were operated on come back in,” Dr. Trabulsi notes. “If we can show that we reliably hit the areas of cancer based on the ultrasound results and didn’t miss any, it’s a home run.”

Source: Thomas Jefferson University

Explore further: Contrast-enhanced ultrasound better detects high-grade prostate cancers with fewer biopsies

Related Stories

Contrast-enhanced ultrasound better detects high-grade prostate cancers with fewer biopsies

September 27, 2012
Contrast-enhanced ultrasound was found to better detect high-grade prostate cancer than conventional methods, making it a more appropriate approach for screening clinically important cancers and monitoring low-risk ones with ...

New technology fuses MRI, ultrasound to achieve targeted biopsy of prostate cancer

May 11, 2011
Targeted biopsy, a major advance in prostate cancer diagnostics, was detailed by a UCLA team in the current issue of Urologic Oncology. The new technology fuses MRI with real-time 3D ultrasound, providing an exacting method ...

Fusion targeted prostate biopsy proves more accurate in diagnosis of prostate cancer

September 14, 2016
New research confirms that an innovative procedure combining MRI and ultrasound to create a 3-D image of the prostate can more accurately locate suspicious areas and help diagnose whether it's prostate cancer.

Researchers find protein signatures for accurate noninvasive diagnosis of prostate cancer

June 28, 2016
Researchers at the Ontario Institute for Cancer Research (OICR) and University Health Network (UHN) in Toronto, along with researchers at the Eastern Virginia Medical School, have created protein signatures that accurately ...

Novel imaging technique improves prostate cancer detection

January 6, 2015
In 2014, prostate cancer was the leading cause of newly diagnosed cancers in men and the second leading cause of cancer death in men. Writing in the January 6, 2015 issue of the journal Prostate Cancer and Prostatic Disease, ...

Unexpected toughness may mark out cancer cells in the blood

December 4, 2012
(Medical Xpress)—A surprising discovery about the physical properties of cancer cells could help improve a new diagnostic approach – a liquid biopsy – that detects, measures, and evaluates cancer cells in blood.

Recommended for you

Hibernating ground squirrels provide clues to new stroke treatments

November 17, 2017
In the fight against brain damage caused by stroke, researchers have turned to an unlikely source of inspiration: hibernating ground squirrels.

Molecular guardian defends cells, organs against excess cholesterol

November 16, 2017
A team of researchers at the Harvard T. H. Chan School of Public Health has illuminated a critical player in cholesterol metabolism that acts as a molecular guardian in cells to help maintain cholesterol levels within a safe, ...

Prototype ear plug sensor could improve monitoring of vital signs

November 16, 2017
Scientists have developed a sensor that fits in the ear, with the aim of monitoring the heart, brain and lungs functions for health and fitness.

Ancient enzyme could boost power of liquid biopsies to detect and profile cancers

November 16, 2017
Scientists are developing a set of medical tests called liquid biopsies that can rapidly detect the presence of cancers, infectious diseases and other conditions from only a small blood sample. Researchers at The University ...

FDA to crack down on risky stem cell offerings

November 16, 2017
U.S. health authorities announced plans Thursday to crack down on doctors pushing stem cell procedures that pose the gravest risks to patients amid an effort to police a burgeoning medical field that previously has received ...

Engineering the gut microbiome with 'good' bacteria may help treat Crohn's disease

November 15, 2017
Penn Medicine researchers have singled out a bacterial enzyme behind an imbalance in the gut microbiome linked to Crohn's disease. The new study, published online this week in Science Translational Medicine, suggests that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.