PD4-12 3D ACOUSTIC RADIATION FORCE IMPULSE (ARFI) ELASTICITY IMAGING OF PROSTATE CANCER: CORRELATION BETWEEN IN VIVO IMAGING AND WHOLE MOUNT HISTOLOGY

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You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2015PD4-12 3D ACOUSTIC RADIATION FORCE IMPULSE (ARFI) ELASTICITY IMAGING OF PROSTATE CANCER: CORRELATION BETWEEN IN VIVO IMAGING AND WHOLE MOUNT HISTOLOGY Melissa Mendez, Mark Palmeri, Zachary Miller, Tyler Glass, Stephen Rosenzweig, Andrew Buck, John Madden, Thomas Polascik, and Kathryn Nightingale Melissa MendezMelissa Mendez More articles by this author , Mark PalmeriMark Palmeri More articles by this author , Zachary MillerZachary Miller More articles by this author , Tyler GlassTyler Glass More articles by this author , Stephen RosenzweigStephen Rosenzweig More articles by this author , Andrew BuckAndrew Buck More articles by this author , John MaddenJohn Madden More articles by this author , Thomas PolascikThomas Polascik More articles by this author , and Kathryn NightingaleKathryn Nightingale More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.324AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Novel imaging systems are becoming available that may allow for robust, real-time localization of aggressive prostate cancer [PCa] for targeted biopsy and focal therapy applications. In this study, Acoustic Radiation Force Impulse Imaging [ARFI] was assessed for its ability to localize aggressive and indolent disease through comparison to whole mount histopathology. METHODS 29 patients with biopsy confirmed Pca scheduled for radical prostatectomy underwent ARFI imaging using a Siemens Acuson SC2000 scanner with an ER7B side-fire probe. A 3D ARFI prostate volume was acquired immediately prior to surgery. The excised prostate was whole mount sectioned, stained, and inked for Pca. ARFI image volumes were then reviewed and regions suspicious for cancer [ROIs] were identified, blinded to histopathology, and assigned an index of suspicion based on a 3 point scale. The approximate centers of the ARFI ROIs and histopathology lesions were mapped to a standardized 27 region anatomic grid, and correlated using a nearest neighbor approach. Hisotopathology lesions were stratified into four categories: posterior/anterior aggressive and posterior/anterior indolent disease. Indolent disease was considered any lesion with a volume less than 0.5 cm3 and a Gleason grade of 3. Aggressive disease was considered any lesion with a volume more than 0.5 cm3 and/or a Gleason grade greater than 3. RESULTS A total of 49 lesions were identified on histopathology. ARFI identified 29 ROIs, and 27 of these ROIs [PPV: 93.1%, 27/29] correlated with histopathology lesions. We found that ARFI was more sensitive to posterior lesions [Overall: 65%, 26/40; Aggressive disease: 74%, 23/31; Indolent disease: 33%, 3/9] than anterior lesions [Overall: 11%, 1/9; Aggressive Disease: 14%, 1/7; Indolent Disease: none]. CONCLUSIONS ARFI consistently identified pathologically aggressive cancers more commonly than indolent lesions. ARFI's high PPV coupled with its sensitivity toward aggressive disease offers a promising low−cost, portable, real time imaging modality in both diagnostic targeted biopsy and focal, image−guided therapy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e91 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Melissa Mendez More articles by this author Mark Palmeri More articles by this author Zachary Miller More articles by this author Tyler Glass More articles by this author Stephen Rosenzweig More articles by this author Andrew Buck More articles by this author John Madden More articles by this author Thomas Polascik More articles by this author Kathryn Nightingale More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...