Real-Time Elastography Improves Prostate Cancer Detection
Real-time elastography (RTE) significantly improves detection of prostate cancer (PCa) and extracapsular extension compared with grey-scale ultrasonography (GSU), according to researchers.
In a study of 229 men with biopsy-proven PCa who underwent radical prostatectomy, RTE showed a sensitivity of 51% and specificity of 72% for detecting PCa compared with 18% and 90%, respectively, for GSU, investigators reported in BJU International (published online ahead of print). In addition, RTE demonstrated a sensitivity and specificity of 38% and 96% for identifying extracapsular extension versus 15% and 97% for grey-scale ultrasonography.
Malignant tissue in the prostate has a lower elasticity as a result of higher cell density compared with benign tissue. RTE enables areas of higher cell density to be distinguished from area of lower density. The study is the first prospective investigation comparing the findings of RTE and conventional GSU with final pathology.
Patients had a mean age of 64 years (range 42-75 years), a mean PSA level of 10.3 ng/mL, and a mean prostate volume of 42.3 mL.
For the study, Marko Brock, MD, of Ruhr-Universität Bochum, Marienhospital Herne, Herne, Germany, and colleagues stratified prostate glands into six sectors on GSU and RTE and these were compared with histopathologic whole mount sections after surgery. Histopathologic examination confirmed PCa in 894 of 1,374 evaluated sectors (61.8%) and extracapsular extension in 47 patients (21%). Of these 894 sectors, RTE correctly detected 594 cancer-suspicious lesions (66.4%) and GSU detected 215 (24%).