Quantitative microbubble enhanced transrectal ultrasound as a tool for monitoring hormonal treatment of prostate carcinoma

Abstract

BACKGROUND: We quantified changes in prostate carcinoma vascularity treated with anti‐androgens using color Doppler and power transrectal ultrasound in combination with microbubble contrast agent Levovist^®.METHODS: Thirty‐six men with prostate carcinoma were studied at baseline and at intervals during treatment. At each attendance, Levovist^® (10 ml, 300 mg/ml) was given as an iv bolus. Using quantitative analysis, we calculated the pre‐enhancement scores, arrival time, time to peak, peak value, and area under the time‐enhancement curve (AUC). These were compared to pre‐treatment values and serial PSA measurements.RESULTS: The pre‐enhancement, peak value, and AUC each showed a marked response with reductions within one week. The average AUC declined to 68% ± 9% (mean ± standard error) by week 1, 56% ± 9% by week 3, and 20% ± 4% by week 6. A strong correlation with changes in the mean PSA (r = 0.95, P < 0.001) was also measured. In four patients, Doppler indices did not fall with PSA: two patients with the most marked discrepancy relapsed at 6 months.CONCLUSION: The vascular enhancement declined with therapy, similar to PSA. Microbubble enhanced ultrasound can show early response to treatment. Prostate 51: 256–267, 2002.