The Prostate 67:1537^1542 (2007) AProspective RandomizedTrial Comparing Contrast-EnhancedTargetedVersus Systematic UltrasoundGuidedBiopsies:

BACKGROUND:. We performed a prospective randomized trial comparing 5 contrast-enhanced color Doppler (CECD) ultrasound (US) targeted biopsy cores to 10 gray-scale US guided systematic biopsy (SB) cores to determine the impact on the cancer detection rate. METHODS:. We prospectively randomized 100 prostate specific antigen (PSA) screening volunteers with an elevated PSA (1.25 ng/ml and free-to-total PSA< 18%) to undergo contrast-enhanced targeted or SB. Contrast-enhanced targeted biopsies with a limited number of five cores were performed into hypervascular areas of the peripheral zone (PZ) during administration of the US contrast agent SonoVue1 (Bracco, Italy). A subjective grading of the vascularity from0 to 3was used: grade 0, no color signal; 1, lowdensity; 2,mediumdensity; and 3, high density of color signals. Ten SBswere obtained in a standard spatial distribution. Cancer detection rates were compared in the groups. RESULTS:. Cancer was detected in 16/50 subjects (32%) by targeted biopsy, and in 13/50 pat-ients (26%) with SB. The cancer detection rate was significantly better for the targeted approach (P< 0.04, McNemar). The detection rate for targeted biopsy cores (15.6 % or 39/250 cores) was significantly better than for SB cores (6.8 % or 34/500 cores, P< 0.001, McNemar). CONCLUSIONS:. CECD targeted biopsy detected more cancers than SB with a reduce