Contrast-enhanced versus systematic transrectal ultrasound-guided prostate cancer detection: An overview of techniques and a systematic review

An overview is given of the current conventional and contrast-specific transrectal ultrasound (TRUS) techniques for prostate imaging that may be used for guiding biopsy. Subsequently, a systematic literature search resulted in inclusion of four studies that directly compared systematic and contrast-enhanced-targeted TRUS-guided biopsy of the prostate. All four studies revealed that contrast-enhanced-targeted TRUS-guided biopsy significantly improved the positive biopsy core rate. In the largest study, the mean Gleason score of the contrast-enhanced-targeted TRUSC-guided biopsies was significantly higher than that of the systematic biopsies. Future randomized clinical trials, preferably in a non-academic multi-institutional set-up, will have to be per-formed to confirm the value of con trast-enhanced-targeted TRUS-guided biopsy in regular clinical practice. (C) 2007 Elsevier Ireland Ltd. All rights reserved.