Performance Characteristics of Transrectal Shear Wave Elastography Imaging in the Evaluation of Clinically Localized Prostate Cancer: A Prospective Study

Wei, Cheng; Li, Chunhui; Szewczyk-Bieda, Magdalena; Upreti, Dilip; Lang, Stephen; Huang, Zhihong; Nabi, Ghulam

doi:10.1016/j.juro.2018.03.116

Cited by 38 publications

(52 citation statements)

References 26 publications

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“…Of these men, 68 had positive biopsy findings, and ultrasound elastography showed excellent overall performance (AUC, 0.95; sensitivity, 96%; and specificity, 85%). Wei et al investigated a cohort of 212 men with clinically localized PCa using whole‐mount prostatectomy specimens as reference standard and found an excellent diagnostic performance as well (AUC, 0.98; sensitivity, 97%; and specificity, 68%) …”

Section: Discussionmentioning

confidence: 99%

Prostate cancer assessment using MR elastography of fresh prostatectomy specimens at 9.4 T

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Majumdar

Kearney

et al. 2019

Magnetic Resonance in Med

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Purpose Despite its success in the assessment of prostate cancer (PCa), in vivo multiparametric MRI has limitations such as interobserver variability and low specificity. Several MRI methods, among them MR elastography, are currently being discussed as candidates for supplementing conventional multiparametric MRI. This study aims to investigate the detection of PCa in fresh ex vivo human prostatectomy specimens using MR elastography. Methods Fourteen fresh prostate specimens from men with clinically significant PCa without formalin fixation or prior radiation therapy were examined by MR elastography at 500 Hz immediately after radical prostatectomy in a 9.4T preclinical scanner. Specimens were divided into 12 segments for both calculation of storage modulus (G′ in kilopascals) and pathology (Gleason score) as reference standard. Sensitivity, specificity, and area under the receiver operating characteristic curve were calculated to assess PCa detection. Results The mean G′ and SD were as follows: all segments, 8.74 ± 5.26 kPa; healthy segments, 5.44 ± 4.40 kPa; and cancerous segments, 10.84 ± 4.65 kPa. The difference between healthy and cancerous segments was significant with P ≤ .001. Diagnostic performance assessed with the Youden index was as follows: sensitivity, 69%; specificity, 79%; area under the curve, 0.81; and cutoff, 10.67 kPa. Conclusion Our results suggest that prostate MR elastography has the potential to improve diagnostic performance of multiparametric MRI, especially regarding its 2 major limitations: interobserver variability and low specificity. Particularly the high value for specificity in PCa detection is a stimulating result and encourages further investigation of this method.

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Section: Discussionmentioning

confidence: 99%

Prostate cancer assessment using MR elastography of fresh prostatectomy specimens at 9.4 T

Reiter

Majumdar

Kearney

et al. 2019

Magnetic Resonance in Med

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“…Woo et al found significant linear correlations between Gleason score and mean stiffness (r = 0.343, p = 0.002) and mean stiffness ratio (r = 0.296, p = 0.008) [38]. A study by Wei et al showed increasing stiffness by tumor grade (91.6, 102.3, and 131.8 kPa for Gleason scores 6, 7, and C 8) with benign tissue measuring 58.3 kPa [41].…”

Section: Review Of Literaturementioning

confidence: 96%

“…In a study with 60 patients, Boehm et al found that PCA (88 kPa) to be stiffer than benign tissue (42 kPa, p \ 0.001) and sensitivity, specificity, PPV, and NPV of 80.9, 69.1, 67.1, and 82.2% using a cut-off of 50 kPa [40]. A recent prospective study of 212 men showed that a cut-off of 82.6 kPa had a high sensitivity (96.8%) with specificity of 67.8% and AUC of 0.976 [41]. However, Porsch et al found poor results in a smaller number of patients (n = 10) with a cut-off of 50 kPa, producing sensitivity, specificity, and AUC of 74%, 43%, and 0.527 [42].…”

Section: Review Of Literaturementioning

confidence: 99%

Prostate Cancer Detection and Diagnosis: Role of Ultrasound with MRI Correlates

2019

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Purpose of Review Prostate cancer (PCA) detection and diagnosis has rapidly changed in recent years, with medical imaging playing an instrumental component. Multiparametric magnetic resonance imaging (MRI) has led to an alternative diagnostic pathway for patient triage and diagnosis. Ultrasound (US) is already essential to this pathway, and development of new US technologies ensures it will assume an even more important role. Recent Findings Conventional US is widely used for anatomic guidance during prostate biopsy, but has low PCA detection rates. Ultrasound elastography and contrastenhanced US are promising for improving PCA detection, have been utilized in addition to traditional systemic biopsy, and provide complementary information to MRI. Summary Here we summarize the current clinical use and newest developments in prostate US. We also present their MRI correlates with the vision that the two modalities will be used closely together in the future to improve PCA care. Keywords Prostate cancer Á Ultrasound Á Ultrasound elastography Á MRI Á Detection Á Diagnosis This article is part of the Topical Collection on Ultrasound.

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“…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.…”

Section: Selected Studies and Quality Assessmentmentioning

confidence: 99%

“…raphy can improve the detection of stiff prostatic tissues [12,13]. However, TRUS is not sufficiently sensitive or specific for biopsy procedures and whether it definitely improves the diagnostic accuracy of PCa detection remains controversial [11,14]. Hence, shear wave elastography (SWE) was introduced in guiding biopsies and for improving the detection of prostate lesions.…”

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confidence: 99%

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

et al. 2019

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Aim: To evaluate the difference in stiffness between prostate cancer (PCa) and benign tissue based on Young’s modulus determined by shear wave elastography (SWE). In addition, the diagnostic accuracy of SWE for the detection of PCa was evaluated comprehensively.Material and methods: We conducted our systematic review and meta-analysis based on databases of PubMed, Embase and Web of Science. Relevant studies regarding to the diagnostic accuracy of SWE for detecting PCa compared to a reference standard of histopathology were included. The pooled weighted mean difference (WMD) of Young’s modulus, sensitivity (SEN) and specificity (SPE), and area under the curve (AUC) were calculated using Stata software.Results: Based on our search strategy, 9 studies were ultimately included. The pooled results indicated that the mean Young’s modulus for detecting prostate cancer was significantly higher than that for prostate benign tissue (WMD = 38.01, 95%CI = 25.59–50.44, p<0.01). In addition, the pooled SEN was 0.86 (95%CI = 0.75–0.92), and the SPE was 0.89 (95%CI = 0.82–0.93). Moreover, an overall high degree of accuracy was indicated by the summary receiver operator characteristic curve with an AUC of 0.94 (95%CI = 0.91–0.95).Conclusion: Our study indicated that SWE is a useful technique for differentiating PCa and benign tissue with a high degree of diagnostic accuracy.

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Performance Characteristics of Transrectal Shear Wave Elastography Imaging in the Evaluation of Clinically Localized Prostate Cancer: A Prospective Study

Abstract: Quantitative shear wave elastography via the transrectal approach accurately detected cancer foci and revealed significant differences between cancerous and benign tissue. Moreover, this technique can be used to reliably phenotype prostate cancer aggressiveness.

Cited by 38 publications

References 26 publications

Prostate cancer assessment using MR elastography of fresh prostatectomy specimens at 9.4 T

Prostate cancer assessment using MR elastography of fresh prostatectomy specimens at 9.4 T

Prostate Cancer Detection and Diagnosis: Role of Ultrasound with MRI Correlates

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

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