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Contrast-enhanced US of the Prostate with Sonazoid: Comparison with Whole-Mount Prostatectomy Specimens in 12 Patients¹

¹ From the Departments of Radiology (E.J.H., P.A.M., F.F.) and Urology (L.G.G.), Jefferson Prostate Diagnostic Center, Thomas Jefferson University, 132 S 10th St, Philadelphia, PA 19107-5244; and Nycomed Amersham, Oslo, Norway (A.K.A., E.K.H.). Received March 8, 2001; revision requested April 11; revision received and accepted June 5. Supported by a grant from Nycomed Amersham. Address correspondence to E.J.H. (e-mail: ethan.halpern@mail.tju.edu).

View larger version (41K): [in a new window]   Figure 1. Map of the prostate used for US and pathologic interpretation. Each gland was mapped in three parts to include the base, midgland, and apex. ant-lat = anterolateral aspect of the outer gland, Lt = left, Rt = right.

View larger version (132K): [in a new window]   Figure 2. Transverse gray-scale US image in a 58-year-old man with a Gleason 7 lesion in the anterior left transition zone demonstrates a focal hypoechoic lesion (arrows).

View larger version (103K): [in a new window]   Figure 3a. US images in a 70-year-old man with Gleason 6 cancer at the base of the prostate, extending along the outer gland from the right side of the midline to the left posterolateral aspect of the gland. (a) Transverse baseline image through the base of the gland demonstrates no lesion. (b) Transverse contrast-enhanced image demonstrates focal enhancement (arrows) in the left posterolateral aspect of the gland, corresponding to the lateral portion of the cancer. Although the tumor extended through the midline, no enhancement is seen posteriorly in the midline.

View larger version (105K): [in a new window]   Figure 3b. US images in a 70-year-old man with Gleason 6 cancer at the base of the prostate, extending along the outer gland from the right side of the midline to the left posterolateral aspect of the gland. (a) Transverse baseline image through the base of the gland demonstrates no lesion. (b) Transverse contrast-enhanced image demonstrates focal enhancement (arrows) in the left posterolateral aspect of the gland, corresponding to the lateral portion of the cancer. Although the tumor extended through the midline, no enhancement is seen posteriorly in the midline.

View larger version (120K): [in a new window]   Figure 4a. US images in a 53-year-old man with Gleason 7 cancer bilaterally, involving the anterolateral portion of the peripheral zone on the right side and the posterolateral portion of the peripheral zone on the left side at the midgland level. (a) Transverse baseline image through the midgland demonstrates no focal lesion. (b) Transverse contrast-enhanced image demonstrates focal enhancement (between cursors) in the right posterolateral aspect of the gland (false-positive enhancement) but no substantial enhancement in the left side (false-negative enhancement).

View larger version (117K): [in a new window]   Figure 4b. US images in a 53-year-old man with Gleason 7 cancer bilaterally, involving the anterolateral portion of the peripheral zone on the right side and the posterolateral portion of the peripheral zone on the left side at the midgland level. (a) Transverse baseline image through the midgland demonstrates no focal lesion. (b) Transverse contrast-enhanced image demonstrates focal enhancement (between cursors) in the right posterolateral aspect of the gland (false-positive enhancement) but no substantial enhancement in the left side (false-negative enhancement).