Diagnostic Value of Transrectal Shear Wave Elastography for Prostate Cancer Detection in Peripheral Zone: Comparison with Magnetic Resonance Imaging

Fu, Shuai; Tang, Yuzhe; Tan, Shengkui; Zhao, Yuqing; Cui, Ligang

doi:10.1089/end.2019.0902

Cited by 15 publications

(18 citation statements)

References 35 publications

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“…PCa has a higher cell and vessel density, which is discernibly stiffer than both benign and normal tissues 177 . Given the noninvasive and cost-effective imaging technology of SWE, several studies have been published aiming to evaluate differences in stiffness between PCa and benign tissue based on Young’s modulus 178 (Table 2 ).…”

Section: Organ-specific Stiffnessmentioning

confidence: 99%

“…The stiffness values corresponding to each Gleason score differ when reported by different studies. For example, the Young’s modulus value to use as a threshold to discriminate benign from malignant prostate tissue has been reported to be 42 180 , 35 181 , or 31 kPa 177 ; and a value of 144 kPa has been proposed as a predictor of biochemical recurrence following radical prostatectomy 182 .…”

Section: Organ-specific Stiffnessmentioning

confidence: 99%

“…Despite inter-variation among the studies, they all agreed on the utility of measuring prostate stiffness by SWE, as this provides additional information for the detection and biopsy guidance of PCa, enabling a substantial reduction in the number of biopsies while ensuring that few peripheral zone adenocarcinomas are missed. SWE can provide information on tissue elasticity, but the combination of this technique with magnetic resonance can improve the detection of PCa 183 and provide guidance for more targeted biopsies rather than systematic ones, thus increasing the positive rate of PCa in targeted biopsies 177 , 184 . The biophysical signature of PCa, characterized by increased stiffness, reduced water diffusion, and increased mechanical fluidity of cancer tissue, correlates with increased cell density and fibrous protein accumulation 185 .…”

Section: Organ-specific Stiffnessmentioning

confidence: 99%

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Causal contributors to tissue stiffness and clinical relevance in urology

et al. 2021

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Mechanomedicine is an emerging field focused on characterizing mechanical changes in cells and tissues coupled with a specific disease. Understanding the mechanical cues that drive disease progression, and whether tissue stiffening can precede disease development, is crucial in order to define new mechanical biomarkers to improve and develop diagnostic and prognostic tools. Classically known stromal regulators, such as fibroblasts, and more recently acknowledged factors such as the microbiome and extracellular vesicles, play a crucial role in modifications to the stroma and extracellular matrix (ECM). These modifications ultimately lead to an alteration of the mechanical properties (stiffness) of the tissue, contributing to disease onset and progression. We describe here classic and emerging mediators of ECM remodeling, and discuss state-of-the-art studies characterizing mechanical fingerprints of urological diseases, showing a general trend between increased tissue stiffness and severity of disease. Finally, we point to the clinical potential of tissue stiffness as a diagnostic and prognostic factor in the urological field, as well as a possible target for new innovative drugs.

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Section: Organ-specific Stiffnessmentioning

confidence: 99%

Section: Organ-specific Stiffnessmentioning

confidence: 99%

Section: Organ-specific Stiffnessmentioning

confidence: 99%

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Causal contributors to tissue stiffness and clinical relevance in urology

et al. 2021

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“…After exclusion of 103 duplicate articles, the remaining 148 articles were screened, and 27 articles were deemed suitable for full-text assessment. Of these, 16 articles were included for quantitative analysis ( Figure 1 ) [ 9 , 10 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Full-text articles were excluded for the following reasons: observer inter/intra reliability studies ( n = 2) [ 28 , 29 ], included overlapping participants ( n = 3) [ 30 , 31 , 32 ], involved alternative elastography technique ( n = 1) [ 33 ], included patients with radioresistant prostate cancer ( n = 1) [ 34 ], or had insufficient diagnostic performance data to reconstruct 2 × 2 tables ( n = 4) [ 35 , 36 , 37 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

Characterisation of Prostate Lesions Using Transrectal Shear Wave Elastography (SWE) Ultrasound Imaging: A Systematic Review

Anbarasan

Wei

Bamber

et al. 2021

Cancers

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Background: ultrasound-based shear wave elastography (SWE) can non-invasively assess prostate tissue stiffness. This systematic review aims to evaluate SWE for the detection of prostate cancer (PCa) and compare diagnostic estimates between studies reporting the detection of all PCa and clinically significant PCa (csPCa). Methods: a literature search was performed using the MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov, and CINAHL databases. Studies evaluating SWE for the detection of PCa using histopathology as reference standard were included. Results: 16 studies including 2277 patients were included for review. Nine studies evaluated SWE for the detection of PCa using systematic biopsy as a reference standard at the per-sample level, with a pooled sensitivity and specificity of 0.85 (95% CI = 0.74–0.92) and 0.85 (95% CI = 0.75–0.91), respectively. Five studies evaluated SWE for the detection of PCa using histopathology of radical prostatectomy (RP) specimens as the reference standard, with a pooled sensitivity and specificity of 0.71 (95% CI = 0.55–0.83) and 0.74 (95% CI = 0.42–0.92), respectively. Sub-group analysis revealed a higher pooled sensitivity (0.77 vs. 0.62) and specificity (0.84 vs. 0.53) for detection of csPCa compared to all PCa among studies using RP specimens as the reference standard. Conclusion: SWE is an attractive imaging modality for the detection of PCa.

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“…Multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound (TRUS) are the primary imaging modalities for characterising PCa prior to biopsy. A grey-scale transrectal ultrasound (TRUS) is a low cost, but has limited sensitivity and specificity (40–50%) in the detection or characterisation of PCa [ 9 , 10 ]. mpMRI has been promising in characterising abnormal areas using PI-RADS score, and studies have reported that MRI-TRUS fusion-guided targeted biopsy of the prostate has a higher detection rate of csPCa compared to systematic biopsy [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Quantitative ultrasound shear wave elastography (USWE)-measured tissue stiffness correlates with PIRADS scoring of MRI and Gleason score on whole-mount histopathology of prostate cancer: implications for ultrasound image-guided targeting approach

et al. 2021

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Objective To correlate quantitative tissue stiffness measurements obtained by transrectal ultrasound shear wave elastography (USWE) with PI-RADS scoring of multiparametric magnetic imaging resonance (mpMRI) using Gleason scores of radical prostatectomy as a reference standard. Patients and methods 196 men with localised prostate cancer were prospectively recruited into the study and had quantitative prostate tissue stiffness measurements in kilopascals (kPa) using transrectal USWE prior to radical prostatectomy. PI-RADS scores of mpMRI were also obtained in all the men. Imaging and histopathology of radical prostatectomy specimen were oriented to each other using patient specific customised 3D moulds to guide histopathology grossing of radical prostatectomy specimens. All included patients had confirmed PCa on TRUS-guided biopsies, had both USWE and mpMRI imaging data, and underwent radical prostatectomy. Chi-square test with 95% confidence interval was used to assess the difference between Gleason score (GS) of radical prostatectomy and PI-RADS classification, as well as GS of radical prostatectomy and stiffness (in Kpa) using USWE. The correlation coefficient (r) was calculated in order to investigate relation between PI-RADS classification and tissue stiffness in kPa. Results There was a statistically significant correlation between USWE-measured tissue stiffness and GS (χ2 (2, N = 196) = 23.577, p < 0.001). Also, there was a statistically significant correlation between Gleason score and PI-RADS score (χ2 (2, N = 196) = 12.838, p = 0.002). High PIRADS on MRI and high stiffness on USWE (> 100 kPa) detected more than 80% and 90% high risk prostate cancer disease. However, a weak correlation coefficient of 0.231 was observed between PI-RADS score and level of tissue stiffness measured in kPa. Conclusion Quantitative USWE and mpMRI using PI-RADS classification provide a good degree of prediction for Gleason score of clinically significant prostate cancer (csPCa). Stiffer lesions on ultrasound showed a weak correlation with PI-RADS scoring system. USWE could be used to target suspected prostate cancer.

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Diagnostic Value of Transrectal Shear Wave Elastography for Prostate Cancer Detection in Peripheral Zone: Comparison with Magnetic Resonance Imaging

Cited by 15 publications

References 35 publications

Causal contributors to tissue stiffness and clinical relevance in urology

Causal contributors to tissue stiffness and clinical relevance in urology

Characterisation of Prostate Lesions Using Transrectal Shear Wave Elastography (SWE) Ultrasound Imaging: A Systematic Review

Quantitative ultrasound shear wave elastography (USWE)-measured tissue stiffness correlates with PIRADS scoring of MRI and Gleason score on whole-mount histopathology of prostate cancer: implications for ultrasound image-guided targeting approach

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