Contrast-enhanced color pixel density in prostate cancer

Erwin Schrödinger Fellowship J 1886 Contrast-enhanced color pixel density in prostate cancer Ferdinand FRAUSCHER 06.03.2000 Prostate cancer is the most commonly diagnosed as well as the second leading cause of cancer death among men worldwide. Three diagnostic tests are routinely used to distinguish benign diseases from malignant tumors: digital rectal examination, prostatespecific antigen and transrectal ultrasound (US) imaging. The tests, however, lack specificity resulting in a large number of unnecessary biopsies and tumor information available once malignancy has been confirmed is limited, which results in inaccurate staging. These facts have prompted research to improve the diagnostic value of current tests in use for prostate cancer detection and staging. One of the areas of interest is the application of color Doppler US. Prostate cancer diagnosis based on color Doppler US flow detection has produced mixed results. One problem may be the lack of sensitivity of Doppler techniques in detecting vessels and flow associated with tumor neovascularity. The morphology of tumor vascularity is an important criteria to evaluate, since the microvessel density detected pathologically is an early and independent prediction of metastatic disease. The sensitivity and specificity of prostate US imaging can be improved by administration of a microbubble-based US contrast agent such as Levovist (R) (Schering) which produces a marked increase in blood flow signal intensities. A computer-assisted assessment of the color pixel density, which has proved helpful for differentiation of benign and malignant breast lesions, will be used to evaluate objectively the increase in the number of color Doppler US signals, the transit time of the microbubble bolus, and the potential additional differential diagnostic information. In this prospective study we will correlate contrast-material enhanced color pixel density with microvessel density to determine the value of this method in differentiating benign from malignant prostatic diseases and its potential role for pathologic staging of prostate cancer.