Real‐time elastography for detecting prostate cancer: preliminary experience

Pallwein, Leo; Mitterberger, Michael; Struve, Peter; Pinggera, Germar M.; Horninger, Wolfgang; Bartsch, Georg; Aigner, Friedrich; Lorenz, A.; Pedross, Florian; Frauscher, Ferdinand

doi:10.1111/j.1464-410x.2007.06851.x

Cited by 159 publications

(105 citation statements)

References 27 publications

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“…6 Peripheral tumor detected at elastography; B-mode US appearance is normal. [41] reported a RTE sensitivity of 87% and specificity of 92% combined with particularly high detection rates in carcinomas affecting the upper lobe of the prostate (100%) and in the mid-glandular region (94%). The role of RTE in targeted biopsy was investigated by Pallwein et al [42], who compared RTE guided targeted biopsy and systematic biopsy in 230 patients.…”

Section: Discussionmentioning

confidence: 99%

“…RTE does not permit identification of small neoplastic lesions, although further development of the method/ equipment may soon permit identification of small anelastic areas of about 5 mm [41]. Tilting of the probe can be useful to overcome lateral stiffness artifacts, but elimination of deep stiffness artifacts is difficult considering that RTE permits adequate evaluation of elasticity only to a depth of about 5 cm [41].…”

Section: Discussionmentioning

confidence: 99%

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Real-time elastography in the diagnosis of prostate tumor

Ferrari

Scorzelli

Megliola

et al. 2009

Journal of Ultrasound

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KEYWORDSProstate cancer; Ultrasonography; Real-time elastography.Abstract Aim: To assess the diagnostic gain of transrectal real-time elastography (RTE) compared to transrectal B-mode ultrasonography (US) in the detection of tumors in patients suspected of having prostate cancer. Materials and methods: Eighty-four patients suspected of having prostate cancer on the basis of clinical and biochemical evaluation underwent transrectal US, RTE and transperineal prostate biopsy. Results: Biopsy was considered the gold standard. Analysis related to the total number of patients showed a B-mode US sensitivity of 56%, specificity 80%, positive predictive value (PPV) 70% and negative predictive value (NPV) 67%. Analysis related to the total number of biopsy cores showed sensitivity 33%, specificity 92%, PPV 69% and NPV 73%. In the patientrelated analysis, RTE sensitivity was 51%, specificity 75%, PPV 64% and NPV 64%, while the core-related analysis showed sensitivity 36%, specificity 93%, PPV 72% and NPV 74%. Comparison of B-mode US and RTE diagnostic accuracy in the detection of tumors located in the peripheral zone of the prostate gland showed a significant difference. Analysis related to the total number of biopsy cores harvested in the peripheral zone of the prostate gland showed a B-mode US sensitivity of 48%, specificity 81%, PPV 75% and NPV 58%, whereas RTE achieved the following values: sensitivity 66%, specificity 78%, PPV 77%, and NPV 67%. Conclusions: RTE is a valid addition to B-mode US, and RTE reached a higher accuracy than Bmode US in the evaluation of the peripheral zone of the prostate gland and in the selection of appropriate biopsy sites.Sommario Scopo: Verificare il guadagno diagnostico dell'elastosonografia transrettale realtime (RTE) rispetto alla ecografia transrettale B-mode nel rilievo del tumore prostatico in una popolazione di pazienti con sospetto di neoplasia. Materiali e metodi: Ottantaquattro pazienti con sospetto clinico-laboratoristico di tumore prostatico sono stati valutati mediante ecografia transrettale, elastosonografia e biopsia transperineale. Risultati: L'esame bioptico è stato considerato lo standard di riferimento. Nella valutazione per paziente, la sensibilità dell'ecografia B-mode è stata del 56%; la specificità dell'80%; il valore predittivo positivo (VPP) del 70%, il valore predittivo negativo (VPN) del 67%. Nella valutazione sul totale dei prelievi bioptici la sensibilità è stata del 33%, la specificità del 92%, il VPP del 69%, il VPN del 73%. La RTE ha ottenuto i seguenti risultati nella valutazione per paziente: sensibilità 51%, specificità 75%, VPP 64% e VPN 64%. Nella valutazione sul totale dei prelievi bioptici: sensibilità 36%, specificità 93%, VPP 72%, VPN 74%. Confrontando i valori di accuratezza dell'ecografia B-mode e della RTE per i tumori della zona periferica, è stata trovata una differenza significativa. Nella valutazione sul totale dei prelievi bioptici della zona periferica la sensibilità dell'ecografia B-mode è stata del 48%, la specificità dell'81%, il VPP d...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-time elastography in the diagnosis of prostate tumor

Ferrari

Scorzelli

Megliola

et al. 2009

Journal of Ultrasound

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“…Pallwein and colleagues 13 found that strain elastography can help to detect prostate cancer and estimate tumour location and size. Salomon and colleagues 14 reported that elastography could detect prostate cancer foci within the prostate with good accuracy and had the potential to increase ultrasound-based prostate cancer detection.…”

Section: -12mentioning

confidence: 99%

Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma

Keskin

Güven

Keskin³

et al. 2015

CUAJ

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E67 ORIGINAL RESEARCHCite as: Can Urol Assoc J 2015;9(1-2):e67-71. http://dx.doi.org/10.5489/cuaj.2349 Published online February 9, 2015. AbstractIntroduction: We evaluate the diagnostic performance of strain elastography to differentiate renal cell carcinoma (RCC) from angiomyolipoma (AML). Methods: Strain elastography was performed in 65 patients (mean age 55.5 years; range: 32-81) who had renal lesions (24 AMLs and 41 RCCs) prospectively. Lesions were classified according to lesion size and histological subtypes. The strain ratios of the RCCs and AMLs were evaluated by a radiologist. The area under the curve and the cut-off point were used to assess diagnostic performance. Sensitivity, specificity, and positive and negative predictive values were obtained. Results: In assessing the mean strain ratio, we divided the groups in 3 according to size: (1) <20-mm lesions; (2) 20-to 40-mm lesions; and (3) >40-mm lesions; the respective mean strain ratios were: 1.5 ± 0.5 (range: 0.06-5.92), 2.8 ± 0.4 (range: 0.17-9.92), 2.7 ± 0.3 (range: 0.08-6.15). When RCCs and AMLs were compared, there was a statistically significant difference in the strain ratio among the 3 groups divided per lesion size (p < 0.01). For the strain ratio, the mean ± standard deviation was 1.1 ± 0.1 for AMLs and 3.4 ± 0.3 for RCCs (p < 0.01). When lesion subtypes were compared, there was a statistically significant difference in the strain ratio between the AML and clear cell RCC (p < 0.01). Conclusions: For assessing renal lesions, strain elastography and strain ratio values may be useful in differentiating RCCs from AMLs. IntroductionUltrasound (US) elastography is a new radiological modality. In conventional B-mode imaging, tissue hardness in real time is represented in colour. Because most malignant tumours are harder than benign tissues, benign and malignant tissues were differentiated significantly by this technique. In the literature, a good correlation between strain elastography and histologic analysis was reported, with high sensitivity and specificity for differentiation between benign and malignant masses in breast tissue. 1 We hypothesized that evaluation of tissue elasticity might be useful for renal mass characterization. Tan and colleagues found significant differences between strain ratios for angiomyolipomas (AMLs) and renal cell carcinomas (RCCs) (p < 0.01).2 The aim of our study, therefore, was to prospectively determine the diagnostic efficiency of sonoelastography for differentiating RCCs from AMLs. Methods Study populationThere were 65 patients in our study population (28 men and 37 women) who underwent US, including elastography of a renal mass, at our institution between March 2012 and February 2013. The mean age of patients was 55.5 ± 12.3 (range: 32-81). The study population had various renal masses, including 41 RCCs and 24 AMLs. The RCCs were diagnosed by resection. The histopathological examination was performed by our pathologists. Histological subtype was clear cell carcinoma in 26 patients, papillary cell carcinoma ...

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“…The hardness of tissues or lesions is visually and qualitatively assessed on the basis of the strain distribution and pattern of elastographic images. 1,[6][7][8][9][10]12,[15][16][17][19][20][21][22][23][24] Semi-quantitative analysis, in which strain is represented in numerical values, has recently been used as a more objective method. [1][2][3][4][5][9][10][11]13,17 However, whether these values can be effectively used for clinical assessment remains unclear because the image quality of strain elastography, which is performed manually, depends strongly on the imaging procedure.…”

Section: Introductionmentioning

confidence: 99%

“…The technique has been used to assess the hardness of various normal and abnormal tissues, [1][2][3][4][5][6] and to differentiate malignant from benign lesions in the breast, prostate, thyroid, lymph nodes and salivary glands. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Ultrasound elastography uses either strain or shear wave velocity. 25,26 In strain elastography, tissue strain induced by compression with the probe is used as an indicator of hardness.…”

Section: Introductionmentioning

confidence: 99%

Effects of compression force on elasticity index and elasticity ratio in ultrasound elastography

Imaizumi¹,

Sasaki²,

Sakamoto³

et al. 2014

Dentomaxillofacial Radiology

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Objectives: The purpose of this study was to investigate the relationship between compression force and hardness values in ultrasound elastography. Methods: Ultrasound elastography was performed using an elastography phantom, comprising inclusions with different elasticities and echogenicities. The compression force was set to approximately 100 gw (light force) and approximately 500 gw (heavy force). The elasticity index (EI) of the inclusion was measured. The EI was a relative hardness value of a structure within an elastographic image. Similarly, the EI of the background was measured as a reference. The elasticity ratio (ER) was calculated as the EI of the inclusion divided by the EI of the reference. Results: The hardness of the phantom could be discerned with both the EI and ER, regardless of the compression force. The EI and ER with heavy force tended to be higher than those with light force, but the difference was not significant. A strong correlation was observed between the EI and ER of soft structures, whereas the correlation between the EI and ER of hard structures was weak, and the ER values varied widely.

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Real‐time elastography for detecting prostate cancer: preliminary experience

Cited by 159 publications

References 27 publications

Real-time elastography in the diagnosis of prostate tumor

Real-time elastography in the diagnosis of prostate tumor

Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma

Effects of compression force on elasticity index and elasticity ratio in ultrasound elastography

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