Real-time sonoelastography in the diagnosis of prostate cancer.

Abstract

AIMS: Sonoelastography (SEG) is a noninvasive ultrasound (US) method able to differentiate tissues according to their stiffness. Our objective was to establish whether transrectal (TR) SEG may improve prostate cancer detection, alone or associated with other US methods. PATIENTS AND METHODS: We analyzed the data of 65 patients, mean age 68 years (49 - 81 years), examined March 2009-September 2010. The patients had at least one of the following malignancy suspicion criteria: PSA > 4 ng /ml (minimum 2 determinations), nodule(s) at digital rectal examination (DRE +) or previous gray scale TRUS positive appearance. All patients underwent TRUS, Doppler-US and SEG in the same session, followed by systematic prostate biopsies (6-12 cores). Histopathology and imaging findings were correlated. RESULTS: Twenty-eight out of 65 patients (43%) were diagnosed with prostate cancer. Overall, SEG had a sensitivity of 67.85%, specificity 62.16%, positive predictive value 57.57% and negative predictive value 71.85%. However, SEG diagnostic reliability appeared to be higher for subgroups of patients having PSA >10 ng / ml, lower number of fragments collected by PBP (6 vs. 10-12 cores) and age > 70 years. CONCLUSION: SEG appears to be useful in the diagnosis of prostate cancer as it may increase the diagnosis accuracy in specific target groups.