title: Value of real-time elastography targeted biopsy for prostate cancer detection in men with prostate specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less.
abstract: OBJECTIVE
  We assessed the prostate cancer detection rate of real-time elastography targeted biopsy in men with total prostate specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less.
  
  
  METHODS
  Real-time elastography using an EUB 8500 Hitachi ultrasound system (Hitachi Medical, Tokyo, Japan) was done in 94 men with a mean age of 57.4 years (range 35 to 77) with increased prostate specific antigen between 1.25 ng/ml or greater and 4.00 ng/ml or less (mean 3.20, range 1.30 to 4.00) and a free-to-total prostate specific antigen ratio of less than 18%. Real-time elastography was done to evaluate peripheral zone tissue elasticity and hard areas were defined as suspicious. Targeted biopsies with a maximum of 5 cores were done in suspicious areas, followed by 10-core systematic biopsy. We analyzed the cancer detection rate of real-time elastography and systematic biopsy.
  
  
  RESULTS
  Cancer was found in 27 of 94 patients (28.7%). Real-time elastography detected cancer in 20 patients (21.3%) and systematic biopsy detected it in 18 (19.1%). Positive cancer cores were found in real-time elastography targeted cores in 38 of 158 cases (24%) and in systematic cores in 38 of 752 (5.1%) (chi-square test p <0.0001). The cancer detection rate per core was 4.7-fold greater for targeted than for systematic biopsy.
  
  
  CONCLUSIONS
  Real-time elastography targeted biopsy allows prostate cancer detection in men with prostate specific antigen 1.25 ng/ml or greater and 4 ng/ml or less with a decreased number of cores compared with that of systematic biopsy.
authors.affiliation: Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria. friedrich.aigner@uki.at
authors.forename: Friedrich
authors.initials: F
authors.lastname: Aigner
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Daniel
authors.initials: D
authors.lastname: Junker
authors.forename: Georg
authors.initials: G
authors.lastname: Schäfer
authors.forename: Gregor
authors.initials: G
authors.lastname: Mikuz
authors.forename: Florian
authors.initials: F
authors.lastname: Pedross
authors.forename: Michael Josef
authors.initials: MJ
authors.lastname: Mitterberger
authors.forename: Werner
authors.initials: W
authors.lastname: Jaschke
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Halpern
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D054459:Elasticity Imaging Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen