Correlation between microvessel maturity and ISUP grade assessed using contrast-enhanced transrectal ultrasonography in prostate cancer

Objectives: In prostate cancer (PCa), microvessel maturity may be useful in distinguishing cancers with aggressive potential. In this study, we aimed to assess the correlation among the contrast enhancement patterns and peak intensity (PI) values of quantitative parameters, microvessel density (MVD), microvessel maturity, and International Society of Urological Pathology (ISUP) grades in biopsy specimens from PCa patients. Methods: : The study population included PCa patients who underwent targeted and systematic biopsy, without radiation or chemohormonal therapy prior to biopsy. Contrast-enhanced transrectal ultrasonography (CE-TRUS) was performed in all patients before biopsy. Contrast enhancement patterns and PI values of quantitative parameters were observed. Tumor tissue samples were immunostained for CD31 expression. MVD, microvessel maturity, and ISUP grades were determined in the prostate biopsy specimens. Results: : Based on the contrast enhancement patterns of prostate lesions, 16 patients were assigned to a low-enhancement group and 45 to a high-enhancement group. The number of mature vessels, MVD, mature vessel index, and ISUP grades were all higher in the high-enhancement group than in the low-enhancement group (all P <0.05). The immature vessel index was lower in the high-enhancement group than in the low-enhancement group ( P <0.05). The PI value was positively correlated with the number of mature vessels ( r =0.372). Conclusions: : In conclusion, enhancement patterns on CE-TRUS were found to reflect microvessel maturity in PCa. Although the PI value was positively correlated with the number of mature vessels, the correlation was weak. Thus, the PI value is not likely a good indicator of PCa prognosis or characteristics.