What is a prostate ultrasound? Ultrasound is a widely used imaging modality to evaluate the prostate. The main purpose of the ultrasound examination of the prostate gland is the timely diagnosis of prostate cancer. Prostate biopsy is performed only under ultrasound guidance, but new imaging techniques allow visualization of prostate cancer and therefore improved detection of the disease. Emerging methods such as contrast-enhanced color Doppler, contrast-specific ultrasound techniques, and elastography may dramatically change the role of ultrasound in prostate cancer diagnosis. Recent technical advances have led to new aspects in prostate research. Ultrasound is a widely used and well-tolerated imaging modality for the evaluation of the prostate gland. Structural analysis of the gland is used to measure prostate volume, examine echotexture, and illustrate tissue stiffness or elasticity. Functional analysis illustrates macrovascularity and microvascularity, which are indicators of tissue perfusion (perfusion). What is the function of the prostate? The prostate gland produces and secretes an alkaline fluid (prostatic secretion) that energizes and protects sperm during ejaculation. Normally, the prostate changes and enlarges as a man ages. Prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer are the most common types of prostate disease. Prostate cancer is the most common malignancy in men. Transrectal ultrasound (TRUS) is a widely used imaging modality for prostate evaluation. The advantages of TRUS over other methods are low cost, good accessibility and the ability to visualize the prostate in real time. However, detection and delineation of prostatic pathology with imaging remains a challenge. What does a transrectal prostate ultrasound consist of? Transrectal prostate echography is the creation of an image of the prostate gland and adjacent organs with the help of ultrasound and with access through the right intestine (rectum). By several rotations of the transducer (a special device through which ultrasound waves are sent to the inside of the body), an entire image of the prostate gland is obtained. Transrectal Color Doppler Color Doppler imaging is well established to illustrate the macrovascularity and therefore perfusion of the prostate. Prostate cancer has an increased density of microvessels compared to healthy prostate tissue. Therefore, Doppler visualization of flowing blood in the vasculature (the location of blood vessels in an organ or part of the body) can help detect and localize prostate cancer.Transrectal contrast-enhanced color Doppler examination Transrectal contrast-enhanced Doppler examination can be used to illustrate macrovascularity and microvascularity. In this research method, microbubbles with a lipid or galactose shell, filled with an inert gas and 1�10 ?m in diameter, are administered intravenously. These microbubbles can be used as an amplifier for the reflection (echo) of the ultrasound waves, leading to visualization of the blood flow in the microvessels. New contrast agents and new techniques for using ultrasound are constantly being developed. References: 1. Ismail M, Gomella LG. Ultrasound for prostate imaging and biopsy 2. Pallwein L, Mitterberger M, Pelzer A, et al. Ultrasound of prostate cancer: recent advances 3. Eri LM, Thomassen H, Brennhovd B, et al. Accuracy and repeatability of prostate volume measurements by transrectal ultrasound