Novel application of three-dimensional shear wave elastography in the detection of clinically significant prostate cancer

Abstract

Abstract. The present study evaluated three-dimensional shear wave elastography (3D SWE) in the detection of clinically significant prostate cancer. Clinically significant prostate cancer was defined by a minimum of one biopsy core with a Gleason score of 3+4 or 6 with a maximum cancer core length >4 mm. Patients with serum prostate-specific antigen levels of 4.0-20.0 ng/ml who were suspected of having prostate cancer from multi-parametric magnetic resonance imaging (mpMRI) were prospectively recruited. The 3D SWE was performed pre-biopsy, after which patients underwent MRI-transrectal ultrasound image-guided targeted biopsies for cancer-suspicious lesions and 12-core systematic biopsies. The pathological biopsy results were compared with the mpMRI and 3D SWE images. A total of 12 patients who were suspected of having significant cancer on mpMRI were included. The median pre-biopsy PSA value was 5.65 ng/ml. Of the 12 patients, 10 patients were diagnosed as having prostate cancer. In the targeted biopsy lesions, there was a significant difference in Young's modulus between the cancer-detected area (median 64.1 kPa, n=20) and undetected area (median 30.8 kPa, n=8; P<0.0001). On evaluation of receiver operating characteristics, a cut-off value of the Young's modulus of 41.0 kPa was used for the detection of clinically significant cancer, with which the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of cancer detection were 58, 97, 86 and 87%, respectively. When combining this cut-off tissue elasticity value with Prostate Imaging Reporting and Data System (PI-RADS) scores, the sensitivity, specificity, positive predictive value and negative predictive value of cancer detection were improved to 70, 98, 91 and 92%, respectively. In the cancer-detected lesions, a significant correlation was identified between the tissue elasticity value of the lesions and Gleason score (r=0.898, P<0.0001). In conclusion, PI-RADS combined with measurement of Young's modulus by 3D SWE may improve the diagnosis of clinically significant prostate cancer.

Automated multiparametric localization of prostate cancer based on B-mode, shear-wave elastography, and contrast-enhanced ultrasound radiomics

“…In a clinical setting, the use of more planes per patient would reduce the risk of missing out-of-plane tumors at the cost of an increased procedure time. However, as 3D SWE and DCE-US have recently been introduced [55,56], expansion to three dimensions can be envisaged.…”

Value of shear wave elastography for diagnosis of primary prostate cancer: a systematic review and meta-analysis

“…The results showed that the AUC of the scoring system based on SWE plus the clinical parameters (0.911) was significantly more diagnostically efficient than the scoring systems based on SWE alone (0.842) or clinical parameters alone (0.868). In addition, Shoji et al [29] indicated that combining Prostate Imaging Reporting and Data System Scores (PI-RADS) with measurement of Young's modulus by three-dimensional SWE improved the diagnosis of clinically significant prostate cancer. Moreover, Zhang et al [41] also demonstrated that multiparametric TRUS including greyscale imaging, colour Doppler imaging, SWE and contrast-enhanced ultrasound yielded a higher SEN, negative predictive value and accuracy than did multiparametric MRI (97.4% versus 94.7%, 96.9% versus 92.3% and 87.2% versus 76.9%, respectively) for detecting localized PCa.…”

“…A total of 217 published studies were identified from the datasets in accordance with our search strategy. After removing the duplicates, screening the title and abstract and carrying out further evaluation, 13 studies were identified that use SWE for diagnosis of PCa; however, two studies provided insufficient data [28,29], one study was based on a total number of patients <20 [22] and one study enrolled patients with recurrent PCa [30]; hence, 9 studies were ultimately included in our present study [9,11,[31][32][33][34][35][36][37] (fig 1). Among the included studies, the study by Ahmad et al [9] was analysed twice according to PSA groupings of 4-20 ng/ml and over 20 ng/ml.…”

Evaluation of the Differences between Normal and Cancerous Prostate Tissue Response to Simple and Vibro-Neural Stimulation

“…The application of 3D shear wave elastography for clinical prostate cancer detection was proposed by Shoji et al 8 In their research, they used ultrasound pulse pressure to create shear waves in tissues, and they utilized this pulse as a means to measure tissue elasticity, which required trans-rectal guidance of the pulse to the prostate tissue. In this method, sensitivity, specificity, positive prediction, and negative prediction improved by 70%, 98%, 91%, and 92% in prostate tissue, respectively, and prostate lesions elasticity significantly correlated with Gleason score.…”

“…In this method, sensitivity, specificity, positive prediction, and negative prediction improved by 70%, 98%, 91%, and 92% in prostate tissue, respectively, and prostate lesions elasticity significantly correlated with Gleason score. 8 Alizad et al and Mitri et al examined the application of vibro-acoustography in prostate tissue imaging and pointed out that the VA may use in clinical in-vivo prostate imaging. 9,10 There are also several neural simulations studies [11][12][13][14][15][16][17][18][19][20] ; however, artificial tactile sense and its applications widely used for mass detection.…”