Accuracy of shear wave elastography for the diagnosis of prostate cancer: A meta-analysis

Abstract

Many studies have established the high diagnostic accuracy of shear wave elastography (SWE) for the detection of prostate cancer (PCa); however, its utility remains a subject of debate. This meta-analysis sought to appraise the overall accuracy of SWE for the detection of PCa. A literature search of the PubMed, Embase, Cochrane Library, Web of Science and CNKI (China National Knowledge Infrastructure) databases was conducted. In all of the included studies, the diagnostic accuracy of SWE was compared with that of histopathology, which was used as a standard. Data were pooled, and the sensitivity, specificity, area under the curve (AUC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to estimate the accuracy of SWE. The pooled sensitivity and specificity for the diagnosis of PCa by SWE were 0.844 (95% confidence interval: 0.696–0.927) and 0.860 (0.792–0.908), respectively. The AUC was 0.91 (0.89–0.94), the PLR was 6.017 (3.674–9.853), and the NLR was 0.182 (0.085–0.389). The DOR was 33.069 (10.222–106.982). Thus, SWE exhibited high accuracy for the detection of PCa using histopathology as a diagnostic standard. Moreover, SWE may reduce the number of core biopsies needed.

Diagnostic Performance of Multiparametric Transrectal Ultrasound in Localized Prostate Cancer: A Comparative Study With Magnetic Resonance Imaging

“…9,10 Shear wave elastography (SWE) is another diagnostic technique that can assess prostate stiffness, which is higher in PCa than benign tissue. [11][12][13][14] However, we did not find a published report comparing multiparametric TRUS, including grayscale imaging, color Doppler imaging, CEUS, and SWE, with multiparametric MRI in the diagnosis of PCa during our literature review.…”

“…All patients maintained a left-lateral lie position with bent knees. Conventional ultrasound (US) examinations were performed with an Aixplorer US system (SuperSonic Imagine, Aix-en-Provence, France) using an SE12-3 transrectal end-fire probe (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Grayscale and color Doppler imaging was performed by measuring 3 diameters of the prostate to observe the suspicious lesions ( Figures 1 and 2).…”

Elastography in prostate gland imaging and prostate cancer detection

“…Sang et al [35] and Woo et al [36] found that SWE showed an excellent PCa detection rate. The lack of consensus regarding the stiffness cut-off values differentiating the malignant and benign tissues made it difficult to standardize SWE guided biopsy.…”

“…In the past decade, six meta-analyses discussing the application of elastography as a tool for a prostate cancer imaging were published (Table I) [23,[33][34][35][36][37]. In all available studies, TRES showed superiority in PCa detection in comparison to standard TRUS.…”

Prostate ultrasound: back in business!

“…This type of elastography has the advantage of providing quantitative information regarding the tissue stiffness and deformation, with no difference in the intra-observer reproducibility [39]. The two studies published so far that compared SWE with sextant prostate biopsy demonstrated high sensitivity and specificity for the diagnosis of PCa (96% and 95% in the first study 90% and 80% in the second study) [40,41].…”