Download PDF
Aktuelle Urol 2012; 43(05): 321-329
DOI: 10.1055/s-0032-1323666
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Bildgestützte Prostatastanzbiopsie

Image-Guided Punch Biopsy of the Prostate
M. Seitz
1   UroClinic Bogenhausen, München
,
C. Gratzke
2   Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München
,
C. Stief
2   Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München
,
D. Tilki
2   Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München
› Author Affiliations
Further Information

Publication History

Publication Date:
18 September 2012 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Diagnose Prostatakarzinom wird nach wie vor über eine Probeentnahme aus der Prostata gestellt. Nach klinischer Einführung des transrektalen Ultraschalls vor beinahe 30 Jahren hat diese Technik einige Innovationen und Änderungen bei der Durchführung erlebt. Die Verbesserung der Schallköpfe und der Ultraschallgeneratoren ist nicht abgeschlossen. Inzwischen stehen auch zum B-mode Verfahren ergänzende Methoden zur Verfügung, die eine Verbesserung der Diagnose ermöglichen. Neben ultraschallbasierten Verfahren, wie C-TRUS/ANNA, Kontrastmittel-verstärktem Ultraschall (CEUS) und Sonoelastografie, stehen MRT-basierte Verfahren zur Auswahl, um die Diagnose Prostatakarzinom zu verbessern. Letztlich wird sich zeigen, welches Verfahren in der Zukunft die höchste diagnostische Sicherheit mit einer angemessenen Kosteneffizienz vereint. Aus urologischer Sicht muss allerdings die Diagnostik und Therapie in der urologischen Hand bleiben.

Abstract

The diagnnosis of prostate cancer is still being made on the basis of biopsy samples taken from the prostate. After the clinical introduction of transrectal sonography almost 30 years ago, this technique has undergone some innovations and changes in its methods of performance. Improvements in the transponder and ultrasound generator are not yet at an end. In the mean time supplementary methods to the B-mode imaging are available that enable improvements in the diagnosis. Apart from ultrasound-based procedure such as C-TRUS/ANNA, contrast medium-enhanced ultrasound (CEUS) and sonoelastography, MRI-based methods are now available to further improve the diagnosis of prostate cancer. It remains to be seen which method will establish itself in the future with the highest degree of diagnostic certainty and an appropriate cost-use relationship. From the urologist’s point, however, diagnosis of and therapy for prostate cancer must remain in the domaine of urology.

Schlüsselwörter

Diagnostik - Prostata - Prostatakarzinom - Prostatastanzbiopsie - Kontrastmittel-verstärktem Ultraschall (CEUS) - Sonoelastografie

Key words

diagnostics - prostate - prostate cancer - punch biopsy of the prostate - contrast medium enhance ultrasound (CEUS) - sonoelastography

Editorial Comment zur Übersicht

 

  • Literatur

  • 1 Nesbitt JA, Drago JR, Badalament RA. Transrectal ultrasonography. Early experience with use as prostate cancer detection tool. Urology 1989; 34: 120-122
    CrossrefPubMedSearch in Google Scholar
  • 2 McNeal JE. The zonal anatomy of the prostate. The Prostate 1981; 2: 35-49
    PubMedSearch in Google Scholar
  • 3 Rifkin MD, Dahnert W, Kurtz AB. State of the art: endorectal sonography of the prostate gland. AJR Am J Roentgenol 1990; 154: 691-700
    CrossrefPubMedSearch in Google Scholar
  • 4 Dahnert WF, Hamper UM, Eggleston JC et al. Prostatic evaluation by transrectal sonography with histopathologic correlation: the echopenic appearance of early carcinoma. Radiology 1986; 158: 97-102
    PubMedSearch in Google Scholar
  • 5 Seitz M, Scher B, Scherr M et al. Imaging procedures to diagnose prostate cancer. Urologe A 2007; 46: W1435-W1446 quiz W1447-W1438
    CrossrefPubMedSearch in Google Scholar
  • 6 Cornud F, Belin X, Piron D et al. Color Doppler-guided prostate biopsies in 591 patients with an elevated serum PSA level: impact on Gleason score for nonpalpable lesions. Urology 1997; 49: 709-715
    CrossrefPubMedSearch in Google Scholar
  • 7 Halpern EJ, Strup SE. Using gray-scale and color and power Doppler sonography to detect prostatic cancer. AJR Am J Roentgenol 2000; 174: 623-627
    CrossrefPubMedSearch in Google Scholar
  • 8 Song JM, Kim CB, Chung HC et al. Prostate-specific antigen, digital rectal examination and transrectal ultrasonography: a meta-analysis for this diagnostic triad of prostate cancer in symptomatic korean men. Yonsei Med J 2005; 46: 414-424
    CrossrefPubMedSearch in Google Scholar
  • 9 Brawer MK, Deering RE, Brown M et al. Predictors of pathologic stage in prostatic carcinoma. The role of neovascularity. Cancer 1994; 73: 678-687
    CrossrefPubMedSearch in Google Scholar
  • 10 Kuligowska E, Barish MA, Fenlon HM et al. Predictors of prostate carcinoma: accuracy of gray-scale and color Doppler US and serum markers. Radiology 2001; 220: 757-764
    CrossrefPubMedSearch in Google Scholar
  • 11 Sauvain JL, Palascak P, Bourscheid D et al. Value of power doppler and 3D vascular sonography as a method for diagnosis and staging of prostate cancer. Eur Urol 2003; 44: 21-30 discussion 30-21
    CrossrefPubMedSearch in Google Scholar
  • 12 Rifkin MD, Alexander AA, Helinek TG et al. Color Doppler as an adjunct to prostate ultrasound. Scand J Urol Nephrol Suppl 1991; 137: 85-89
    PubMedSearch in Google Scholar
  • 13 Ismail M, Petersen RO, Alexander AA et al. Color Doppler imaging in predicting the biologic behavior of prostate cancer: correlation with disease-free survival. Urology 1997; 50: 906-912
    CrossrefPubMedSearch in Google Scholar
  • 14 Kelly IM, Lees WR, Rickards D. Prostate cancer and the role of color Doppler US. Radiology 1993; 189: 153-156
    PubMedSearch in Google Scholar
  • 15 Newman JS, Bree RL, Rubin JM. Prostate cancer: diagnosis with color Doppler sonography with histologic correlation of each biopsy site. Radiology 1995; 195: 86-90
    PubMedSearch in Google Scholar
  • 16 Sakarya ME, Arslan H, Unal O et al. The role of power Doppler ultrasonography in the diagnosis of prostate cancer: a preliminary study. Br J Urol 1998; 82: 386-388
    CrossrefPubMedSearch in Google Scholar
  • 17 Cho JY, Kim SH, Lee SE. Diffuse prostatic lesions: role of color Doppler and power Doppler ultrasonography. J Ultrasound Med 1998; 17: 283-287
    PubMedSearch in Google Scholar
  • 18 Cho JY, Kim SH, Lee SE. Peripheral hypoechoic lesions of the prostate: evaluation with color and power Doppler ultrasound. Eur Urol 2000; 37: 443-448
    CrossrefPubMedSearch in Google Scholar
  • 19 Remzi M, Dobrovits M, Reissigl A et al. Can Power Doppler enhanced transrectal ultrasound guided biopsy improve prostate cancer detection on first and repeat prostate biopsy?. Eur Urol 2004; 46: 451-456
    CrossrefPubMedSearch in Google Scholar
  • 20 Cho IR, Keener TS, Nghiem HV et al. Prostate blood flow characteristics in the chronic prostatitis/pelvic pain syndrome. J Urol 2000; 163: 1130-1133
    CrossrefPubMedSearch in Google Scholar
  • 21 Lee HY, Lee HJ, Byun SS et al. Classification of focal prostatic lesions on transrectal ultrasound (TRUS) and the accuracy of TRUS to diagnose prostate cancer. Korean journal of radiology: official journal of the Korean Radiological Society 2009; 10: 244-251
    CrossrefPubMedSearch in Google Scholar
  • 22 http://www.dgu.de/fileadmin/MDB/PDF/S3_ProstataCa_Update_2011_Langversion.pdf. DOI
    PubMed
  • 23 Garg S, Fortling B, Chadwick D et al. Staging of prostate cancer using 3-dimensional transrectal ultrasound images: a pilot study. J Urol 1999; 162: 1318-1321
    CrossrefPubMedSearch in Google Scholar
  • 24 Hamper UM, Trapanotto V, DeJong MR et al. Three-dimensional US of the prostate: early experience. Radiology 1999; 212: 719-723
    PubMedSearch in Google Scholar
  • 25 Strasser H, Frauscher F, Klausser A et al. Three-dimensional transrectal ultrasound in staging of localised prostate cancer. J Urology 2003; 169: 299A
    PubMedSearch in Google Scholar
  • 26 Sedelaar JP, van Roermund JG, van Leenders GL et al. Three-dimensional grayscale ultrasound: evaluation of prostate cancer compared with benign prostatic hyperplasia. Urology 2001; 57: 914-920
    CrossrefPubMedSearch in Google Scholar
  • 27 Mehta SS, Azzouzi AR, Hamdy FC. Three dimensional ultrasound and prostate cancer. World J Urol 2004; 22: 339-345
    CrossrefPubMedSearch in Google Scholar
  • 28 Zhao HX, Zhu Q, Wang ZC. Detection of prostate cancer with three-dimensional transrectal ultrasound: correlation with biopsy results. The British journal of radiology 2012; 85: 714-719
    CrossrefPubMedSearch in Google Scholar
  • 29 Mitterberger M, Pinggera GM, Pallwein L et al. The value of three-dimensional transrectal ultrasonography in staging prostate cancer. BJU Int 2007; 100: 47-50
    PubMedSearch in Google Scholar
  • 30 Zalesky M, Urban M, Smerhovsky Z et al. Value of power Doppler sonography with 3D reconstruction in preoperative diagnostics of extraprostatic tumor extension in clinically localized prostate cancer. International journal of urology: official journal of the Japanese Urological Association 2008; 15: 68-75 discussion 75
    CrossrefPubMedSearch in Google Scholar
  • 31 Bude RO, Rubin JM. Power Doppler sonography. Radiology 1996; 200: 21-23
    PubMedSearch in Google Scholar
  • 32 Yang JC, Tang J, Li J et al. Contrast-enhanced gray-scale transrectal ultrasound-guided prostate biopsy in men with elevated serum prostate-specific antigen levels. Acad Radiol 2008; 15: 1291-1297
    CrossrefPubMedSearch in Google Scholar
  • 33 Seitz M, Gratzke C, Schlenker B et al. Contrast-enhanced transrectal ultrasound (CE-TRUS) with cadence-contrast pulse sequence (CPS) technology for the identification of prostate cancer. Urologic oncology 2011; 29: 295-301
    CrossrefPubMedSearch in Google Scholar
  • 34 Aigner F, Pallwein L, Mitterberger M et al. Contrast-enhanced ultrasonography using cadence-contrast pulse sequencing technology for targeted biopsy of the prostate. BJU Int 2009; 103: 458-463
    CrossrefPubMedSearch in Google Scholar
  • 35 Xie SW, Li HL, Du J et al. Contrast-enhanced ultrasonography with contrast-tuned imaging technology for the detection of prostate cancer: comparison with conventional ultrasonography. BJU Int 2012; 109: 1620-1626
    CrossrefPubMedSearch in Google Scholar
  • 36 http://www.anna-ctrus.de DOI
    PubMed
  • 37 Loch T. Persönliche Mitteilung: Urologisches Winterforum 2011: Workshop Prostatakarzinomdiagnostik. 2011 DOI
    PubMedSearch in Google Scholar
  • 38 Loch T. Core needle biopsy twice negative with rising PSA level. Does imaging help?. Urologe A 2010; 49: 369-375
    CrossrefPubMedSearch in Google Scholar
  • 39 Grabski B, Baeurle L, Loch A et al. Computerized transrectal ultrasound of the prostate in a multicenter setup (C-TRUS-MS): detection of cancer after multiple negative systematic random and in primary biopsies. World J Urol 2011; 29: 573-579
    CrossrefPubMedSearch in Google Scholar
  • 40 Walz J, Thomassin-Piana J, Poizat F et al. External validation of the ANNA/C-TRUS system regarding the correct identification of prostate cancer lesions in the diagnosis of prostate cancer. J Urol Suppl 2012; #2033
    PubMedSearch in Google Scholar
  • 41 Braeckman J, Autier P, Soviany C et al. The accuracy of transrectal ultrasonography supplemented with computer-aided ultrasonography for detecting small prostate cancers. BJU Int 2008; 102: 1560-1565
    CrossrefPubMedSearch in Google Scholar
  • 42 Braeckman J, Autier P, Garbar C et al. Computer-aided ultrasonography (HistoScanning): a novel technology for locating and characterizing prostate cancer. BJU Int 2008; 101: 293-298
    CrossrefPubMedSearch in Google Scholar
  • 43 Epplen R, Van Essen J, Porres D et al. Is Histoscanning a valid tool to detect prostate cancer in repeat biopsy?. Eur Urol Suppl #800 2012;
    PubMedSearch in Google Scholar
  • 44 Tsutsumi M, Miyagawa T, Matsumura T et al. The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis. Int J Clin Oncol 2007; 12: 250-255
    CrossrefPubMedSearch in Google Scholar
  • 45 Konig K, Scheipers U, Pesavento A et al. Initial experiences with real-time elastography guided biopsies of the prostate. J Urol 2005; 174: 115-117
    CrossrefPubMedSearch in Google Scholar
  • 46 Pallwein L, Mitterberger M, Struve P et al. Real-time elastography for detecting prostate cancer: preliminary experience. BJU Int 2007; 100: 42-46
    CrossrefPubMedSearch in Google Scholar
  • 47 Brock M, von Bodman C, Palisaar RJ et al. The impact of real-time elastography guiding a systematic prostate biopsy to improve cancer detection rate: a prospective study of 353 patients. J Urol 2012; 187: 2039-2043
    CrossrefPubMedSearch in Google Scholar
  • 48 Pelzer A, Heinzelbecker J, Kirchner M et al. Real-time elastography compared to 3.0 Tesla MRT findings in the localisation and diagnosis of prostate cancer: Preliminary results of a single centre study. Eur Urol Suppl 2010; Abstract #149
    PubMedSearch in Google Scholar
  • 49 Aigner F, Pallwein L, Schocke M et al. Comparison of real-time sonoelastography with T2-weighted endorectal magnetic resonance imaging for prostate cancer detection. J Ultrasound Med 2011; 30: 643-649
    PubMedSearch in Google Scholar
  • 50 Brock M, von Bodman C, Sommerer F et al. Comparison of real-time elastography with grey-scale ultrasonography for detection of organ-confined prostate cancer and extra capsular extension: a prospective analysis using whole mount sections after radical prostatectomy. BJU Int 2011; 108: E217-E222
    CrossrefPubMedSearch in Google Scholar
  • 51 Eggert T, Khaled W, Wenske S et al. Impact of elastography in clinical diagnosis of prostate cancer. A comparison of cancer detection between B-mode sonography and elastography-guided 10-core biopsies. Urologe A 2008; 47: 1212-1217
    CrossrefPubMedSearch in Google Scholar
  • 52 Barr RG, Memo R, Schaub CR. Shear wave ultrasound elastography of the prostate: initial results. Ultrasound quarterly 2012; 28: 13-20
    CrossrefPubMedSearch in Google Scholar
  • 53 Seitz M, Weiss C, Nanke R et al. MRT/real-time TRUS Fusions-gesteuerte Prostatastanzbiopsie bei der Detektion des Prostatakarzinoms – Eine Pilotstudie. Urologe A Suppl 2010; 143: 54
    PubMedSearch in Google Scholar
  • 54 Singh AK, Kruecker J, Xu S et al. Initial clinical experience with real-time transrectal ultrasonography-magnetic resonance imaging fusion-guided prostate biopsy. BJU Int 2008; 101: 841-845
    CrossrefPubMedSearch in Google Scholar
  • 55 Hadaschik BA, Kuru TH, Tulea C et al. A novel stereotactic prostate biopsy system integrating pre-interventional magnetic resonance imaging and live ultrasound fusion. J Urol 2011; 186: 2214-2220
    CrossrefPubMedSearch in Google Scholar
  • 56 Scheidler J, Weores I, Brinkschmidt C et al. Diagnosis of prostate cancer in patients with persistently elevated PSA and tumor-negative biopsy in ambulatory care: performance of MR imaging in a multi-reader environment. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 2012; 184: 130-135
    PubMedSearch in Google Scholar
  • 57 Hoeks CM, Schouten MG, Bomers JG et al. Three-Tesla Magnetic Resonance-Guided Prostate Biopsy in Men With Increased Prostate-Specific Antigen and Repeated, Negative, Random, Systematic, Transrectal Ultrasound Biopsies: Detection of Clinically Significant Prostate Cancers. Eur Urol 2012;
    PubMedSearch in Google Scholar