Shear Wave Elastography for Detection of Prostate Cancer: A Preliminary Study

Abstract

ObjectiveTo assess the diagnostic value of shear wave elastography (SWE) for prostate cancer detection.Materials and MethodsIn this retrospective study, 87 patients with the suspicion of prostate cancer (prostate-specific antigen > 4 ng/mL and abnormal digital rectal examination) underwent a protocol-based systematic 12-core biopsy followed by targeted biopsy at hypoechoic areas on grey-scale ultrasound. Prior to biopsy, SWE was performed by placing two circular 5 mm-sized regions of interest (ROIs) along the estimated biopsy tract in each sector and one ROI for hypoechoic lesions. SWE parameters, S (mean stiffness) and R (mean stiffness ratio), were calculated and compared regarding different histopathologic tissues and their accuracy for diagnosing prostate cancer was analyzed. SWE parameters were correlated with Gleason score and were compared between indolent (< 8) and aggressive (≥ 8) tissues in prostate cancer patients.ResultsProstate cancer was detected in 7.5% of 1058 cores in 29.9% of 87 patients. Seven (43.8%) of 16 hypoechoic lesions were confirmed as prostate cancer. SWE parameters were significantly different among the histopathologic entities (p < 0.001). Prostate cancer was stiffer than benign tissues (p ≤ 0.003). Sensitivity, specificity and receiver operating characteristic curve area for diagnosing cancer were 43%, 80.8%, and 0.599, respectively, for a cutoff of S > 43.9 kPa and 60.8%, 66.4%, and 0.653, respectively, for R > 3. Both, S and R showed a significant correlation with Gleason score (r ≥ 0.296, p ≤ 0.008) and were significantly different between indolent and aggressive prostate cancer (p ≤ 0.006).ConclusionShear wave elastographic parameters are significantly different between prostate cancer and benign prostate tissue and correlate with Gleason score.

Prediction of Significant Prostate Cancer at Prostate Biopsy and Per Core Detection Rate of Targeted and Systematic Biopsies Using Real-Time Shear Wave Elastography

“…Our results corroborate the findings of Woo et al [19] whose study reports a similar per-core DR (7.5 vs. 9.8%), but a lower DR of csPCa (30 vs. 40%). The proportion of patients additionally diagnosed with SWE-targeted cores was 5% in the current study, confirming the results of our strain elastography study, where elastography targeted cores elevated the overall DR by 7% [20].…”

“…These characteristics are shared with all other series in this field [14,19,22]. Nonetheless, controlled trials in a multicenter setting are mandatory, especially for external validation of our predictive model.…”

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

“…Recent research efforts using SWE in the prostate reported that SWE has high diagnostic accuracy (sensitivity, 90-96%; specificity, 88-96%) for detection of prostate cancer with negative predictive values up to 99.6% [13,14]. Furthermore, it has also been demonstrated that the stiffness derived from SWE correlates with Gleason score with more aggressive prostate cancer showing higher stiffness [15].…”

Kidney Ultrasound Elastography: Review

“…Some of them were about animals [36][37][38][39][40][41][42] , some of them were about MRI or MR elastography [43][44][45][46][47][48][49][50][51][52] , some of them were about other organ systems [53][54][55][56][57][58][59][60][61][62][63][64][65] , some of them were about elastography technic 28,[66][67][68][69] and some of them were about non elastography related kidney studies 70 . We excluded these articles.…”