Initial evaluation of prostate cancer with real‐time elastography based on step‐section pathologic analysis after radical prostatectomy: A preliminary study

Abstract

Objective: To determine whether real-time elastography can be used to detect prostate cancer as a relatively non-invasive modality based on the tissue strain value. Patients and Methods: Seventeen patients underwent real-time elastography in conjunction with digital rectal examination (DRE), conventional gray-scale transrectal ultrasonography (TRUS), color Doppler ultrasonography (CDUS), and magnetic resonance imaging (MRI) prior to radical prostatectomy. The elastogram was compared to findings of conventional modalities and pathological findings of prostatectomy specimens. To obtain the elastogram, compression of the prostate was performed along with a visual indicator on a video screen. Results: Twenty of 27 pathologically confirmed tumors were detected with real-time elastography. The cancer detection rate with real-time elastography was superior to the rates of other modalities and nearly equal to both on the anterior side (75.0%) and the posterior side (73.7%) of the prostate. A higher tumor detection rate for real-time elastography was observed for tumors with a higher Gleason score and larger tumor volume. Conclusion: In our preliminary study, real-time elastography in conjunction with gray-scale TRUS is a non-invasive modality to detect prostate cancer.

Comparison of Real-Time Elastography and Multiparametric MRI for Prostate Cancer Detection: A Whole-Mount Step-Section Analysis

“…4). In accordance with the studies by Sumura et al [14] and Roethke et al [18] dealing with detection rates in relation to tumor volume, in our study both modalities had increasing accuracy for prostate cancer detection with increasing tumor volume. Sumura et al, to our knowledge the first study group to evaluate RTE and MRI in the same patient population, found superiority for RTE in the detection of small cancer lesions compared with T2-weighted MRI and CE-MRI separately.…”

“…We compared diagnostic performance and estimation of tumor volume for RTE and multiparametric MRI in patients with known prostate cancer using prostate whole-mount step section as the standard of reference. To our knowledge, this is only the second study comparing RTE with multiparametric MRI and the fourth comparing RTE with MRI in general [12][13][14].…”

Real-time elastography in the diagnosis of prostate tumor

“…As regards correlation between RTE and Gleason score, Tsutsumi et al [39] observed that RTE reaches a higher detection rate in tumors with low Gleason scores. In contrast, Sumura et al [43] achieved an elevated detection rate in tumors with high Gleason scores. In our study, the biopsy cores obtained in suspicious areas identified at RTE were assigned a Gleason score higher than or identical to the score assigned to the other cores.…”

“…According to the authors, the low sensitivity in carcinomas located in the posterior region could be caused by the fact that the probe easily dislocates posterior lesions. Other authors have observed that RTE is more sensitive than other imaging modalities in the detection of carcinomas located in the anterior zone [43]. Magnetic resonance (MR) is less sensitive in detecting carcinomas located in the anterior zone because of the distance between the tumor site and the coil [11].…”

Transrectal Real-time Tissue Elastography - An Effective Way to Distinguish Benign and Malignant Prostate Tumors

“…Although there is little difference in the elasticity between the different anatomies in normal tissues (Greenleaf et al, 2003), significant differences exist in the bioelasticity of normal and diseased tissues (Agliamov et al, 2000). Previous studies showed that a change in tissue elasticity can occur before the observation of morphological changes in the tissue (Gao et al, 1997;Sumura et al, 2007). Therefore, manual digital rectal examination (DRE) has been used as a means of clinical diagnosis for many centuries.…”