Contrast Enhanced Ultrasound imaging to support prostate cancer brachytherapy treatment and follow up after treatment

Brachytherapy of the prostate is globally used as a treatment for prostate
cancer. Because prostate cancer is a multifocal disease, radiation of the
entire prostate is necessary. New treatment techniques are being used to
increase the radiation dose on those places where cancer existence is proven.
Sensitivity and specificity however of the conventional detection and imaging
techniques for prostate cancer are low. Contrast enhanced ultrasound can detect
abnormal bloodperfusion of the prostate, associated with tumor foci, and thus
improve sensitivity and specificity of tumor detection. The information of
contrast enhanced ultrasound before treatment can be used to adjust the
radiation dose and improve treatment outcomes. The same properties of contrast
enhanced ultrasound of the prostate can be used to improve follow up after
treatment.

To investigate if contrast enhanced ultrasound can improve prostate
brachytherapy outcomes. Besides that we will investigate if contrast enhanced
ultrasound can be used as an extra verification of follow up after treatment.

observational investigation

Giving the patient an iv-line could be uncomfortable for the patient.

A transrectal ultrasound of the prostate can be experienced as uncomfortable by
some patients. However during diagnosing the prostate cancer, the patient
already had a transrectal ultrasound of the prostate at least one time. So the
patient will know what to expect and would not participate when he experienced
the investigation as very unpleasent. The investigation itself will not take
longer than 5 minutes.

The risk of contrast agent sonovue is minimal. Literature mentions 1 case of an
allergic reaction (0,01%). The most frequently mentioned minor side-effects of
microbubble contrast agents are alteration of taste, local pain at the
injection site and facial or general flush. These side-effects are transient,
mild and rare (1-5%).