2313 PROSTATE BIOPSY GUIDED WITH TISSUE ELASTICITY IMAGING - NOVEL APPROACH TO IMPROVE PROSTATE CANCER DETECTION

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology1 Apr 20112313 PROSTATE BIOPSY GUIDED WITH TISSUE ELASTICITY IMAGING - NOVEL APPROACH TO IMPROVE PROSTATE CANCER DETECTION Masahiro Sumura, Chiaki Kobara, Keita Inoue, Naoko Arichi, Yozo Mitsui, Takeo Hiraoka, Koji Wake, Satoshi Honda, Hiroaki Yasumoto, Hiroaki Shiina, and Mikio Igawa Masahiro SumuraMasahiro Sumura Izumo, Shimane, Japan More articles by this author , Chiaki KobaraChiaki Kobara Izumo, Shimane, Japan More articles by this author , Keita InoueKeita Inoue Izumo, Shimane, Japan More articles by this author , Naoko ArichiNaoko Arichi Izumo, Shimane, Japan More articles by this author , Yozo MitsuiYozo Mitsui Izumo, Shimane, Japan More articles by this author , Takeo HiraokaTakeo Hiraoka Izumo, Shimane, Japan More articles by this author , Koji WakeKoji Wake Izumo, Shimane, Japan More articles by this author , Satoshi HondaSatoshi Honda Izumo, Shimane, Japan More articles by this author , Hiroaki YasumotoHiroaki Yasumoto Izumo, Shimane, Japan More articles by this author , Hiroaki ShiinaHiroaki Shiina Izumo, Shimane, Japan More articles by this author , and Mikio IgawaMikio Igawa Izumo, Shimane, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2559AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Real-time tissue elastography is a recently developed novel approach for revealing prostate cancer based on tissue elasticity. In cancer tissues, tissue elasticity elevation is considered to sensitively reflect the condition of the lesion before morphological changes can be detected by ultrasonography, as the lesion may or may not possess echogenic properties to make it ultrasonically detectable. It is expected that elastography will provide new and clinically useful information different from that obtained by usual ultrasound examination. In the present study, we investigated whether objective analysis of prostate tissue elasticity using real-time tissue elastography (RTE) is more useful to detect localized prostate cancer (PC) than a conventional approach with a PC-detection screening program. METHODS This study included 208 patients (38–93 years old, median 72 years) with PSA levels ranging from 0.8-1113.8 ng/ml (median 6.0 ng/ml) who underwent a prostate biopsy procedure, because of a palpable abnormality in digital rectal examination (DRE), elevated serum PSA level, and/or abnormal gray-scale transrectal ultrasonographic (TRUS) findings. All patients underwent TRUS, power Doppler ultrasonography (PDUS), and RTE examinations prior to the prostate biopsy, and none had a known history of prostate carcinoma. To evaluate the utility of RTE, gray-scale, PDUS, and RTE findings recorded prior to the biopsy by a single urologist were used to compare between among those modalities and the biopsy findings. Three analysis strategies were used; a conventional 8-site biopsy-based approach, a targeted biopsy-based approach, and a patient-based approach. RESULTS Prostate cancer was detected in 89 of 208 patients (42.4%). The sensitivity, specificity, and positive predictive value (PPV) of RTE were 88.8%, 96.8%, and 86.2%, respectively, while its negative predictive value (NPV) was 97.4%. All results related to the diagnostic probability of PC detection were higher for RTE than for PDUS or TRUS. Using multivariate analysis with PSA density and prostate volume as variables, PSA density and DRE contributed only weakly to PC detection in the 207 patients with PSA levels below 120 ng/ml, whereas a positive finding by RTE was the variable most significantly associated with PC detection. CONCLUSIONS RTE is simple and noninvasive, and can compensate for the functional limitations of TRUS and PDUS. In addition, it was shown to be effective for early identification of clinically significant cancer with high Gleason score. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e927 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masahiro Sumura Izumo, Shimane, Japan More articles by this author Chiaki Kobara Izumo, Shimane, Japan More articles by this author Keita Inoue Izumo, Shimane, Japan More articles by this author Naoko Arichi Izumo, Shimane, Japan More articles by this author Yozo Mitsui Izumo, Shimane, Japan More articles by this author Takeo Hiraoka Izumo, Shimane, Japan More articles by this author Koji Wake Izumo, Shimane, Japan More articles by this author Satoshi Honda Izumo, Shimane, Japan More articles by this author Hiroaki Yasumoto Izumo, Shimane, Japan More articles by this author Hiroaki Shiina Izumo, Shimane, Japan More articles by this author Mikio Igawa Izumo, Shimane, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...