Microvascular features of the prostate using super-resolution ultrasound

Super-resolution ultrasound imaging (SRUI) is achieved by localising and tracking microbubble echoes in contrast enhanced ultrasound (CEUS). The resulting maps depict the imaged vascular structures. The objective of this work was to assess, in vivo, a new vascular-specific SRUI tracking algorithm incorporating criteria based on vascular characteristics. CEUS video data was collected from prostate cancer cases prior to radical prostatectomy (RP). After RP the specimen underwent macroscopic examination allowing comparison of features in SRUI maps with areas of malignancy and other prostate features. For 15 clinical cases, regions of known cancer, determined from RP pathology, were identified in the SRUI maps. In an initial subset of cases, 16 out of 17 known cancer regions were identified, with faster and higher volume blood flow, and generally wider vessel presentation. In addition to highlighting confirmed regions of cancer, patterns associated with benign prostatic hyperplasia, dilated glands and normal prostate structure such as peri-urethral blood vessels were identified. In conclusion the identification of vascular patterns associated with prostate disease is linked to multiple features that may formulate a multiparametric imaging biomarker.