Elasticity as a biomarker for prostate cancer: a systematic review

Abstract

To systematically review the range of methods available for assessing elasticity in the prostate and to examine its use as a biomarker for prostate cancer. A systematic review of the electronic database PubMed was performed up to December 2012. All relevant studies assessing the use of elasticity as a biomarker for prostate cancer were included except those not studying human prostates or reporting a sensitivity, specificity or quantitative elasticity value. There has been much interest in the use of elasticity in the detection of prostate cancer and there have been many publications using various methods of detection. The most common method of assessment is an imaging method, called sonoelastography. Further imaging methods include ultrasound (US), three‐dimensional US and magnetic resonance elastography. These methods are reviewed for sensitivity and specificity. The other method of assessment is the mechanical method. These use quantitative elasticity values to differentiate benign from malignant areas of the prostate. This method of assessment has shown that the elasticity changes for differing Gleason grades and T stages of disease within the prostate. Quantitative elasticity values offer the potential of using ‘threshold’ elasticity values under which the prostate is benign. Tissue elasticity has great potential as a diagnostic and prognostic biomarker for prostate cancer and can be assessed using various methods. Currently transrectal sonoelastography has the most evidence supporting its use in clinical practice.

Shear wave elastography assessment in the prostate: an intraobserver reproducibility study

“…Although there have been studies emphasizing the diagnostic value of SWE in detecting prostate cancer and demonstrating that SWE-derived parameters correlate with Gleason score, there has been a lack of studies demonstrating reproducibility of this method until now. However, it has generally been expected that SWE would be more reproducible than the more traditional quasistatic or strain elastography due to the following several reasons [17,18]: (i) manual compression and decompression needed to generate the elastograms is relatively uncontrolled and susceptible to wide variability, (ii) artifacts can be caused by inadvertent slippage from the compression plane in up to 32% of the images, (iii) and moreover, interpretation itself of the colored elastogram map introduces an additional source of variation as it is not given in quantitative values [as with the Young modulus (kPa) in SWE] but is rather subjective. Although we did not directly compare the variability of our methods using SWE with that using strain elastography, the results of our study support the widespread idea that SWE has acceptable reproducibility and, with validation from future studies, may have the potential to strengthen its role as an important imaging tool the management of prostate cancer.…”

Utility of Ultrasound in the Diagnosis, Treatment, and Follow-up of Prostate Cancer: State of the Art

“…This stiffening is secondary to increased cellular density, decreased glandular tissue architecture, and increased collagen deposition in the stroma surrounding the tumor (33). The basis of ultrasound elastography is the detection of the elastic difference between prostate cancers and surrounding prostatic tissue.…”

Imaging for Prostate Cancer

“…Analyzing pre-and post-compression images is performed in real time and displayed as a colored overlay on B-scan. Earlier research was directed towards guided biopsy [1,2]. Recently, real-time sonoelastography (RTE) was compared to mpMRI where it, in several cases, performed better than the latter.…”