title: [Real-time elastography in the diagnosis of prostate cancer: personal experience].
abstract: BACKGROUND
  Prostate cancer is the most common cancer in men. In the future, a significant further increase in the incidence of prostate cancer is expected. The indication to perform a prostate biopsy is digital rectal examination suspicious for prostate cancer, total prostate specific antigen (PSA) value, free PSA/total PSA ratio, PSA density and PSA velocity, and an evidence of hypoechoic area at transrectal ultrasound scan. Unfortunately the specificity and sensibility are still poor. The aim of this retrospective study is to evaluate the specificity and sensibility of real time elastography versus ultrasound transrectal B-mode scan.
  
  
  METHODS
  We retrospectively evaluated 108 pts. having undergone TRUS-guided transrectal prostate biopsy (10 samples). The indication for biopsy is: digital rectal examination, total prostate specific antigen (PSA) value, PSA ratio, PSA density and PSA velocity suspicious for prostate cancer, and/or an evidence of hypoechoic area at transrectal ultrasound scan, and/or hard area at real-time elastography. The mean age of patients is 66.8 years, mean PSA 6.5 ng/mL, and mean ratio 16.5%. We compared the histopathological findings of needle prostate biopsies with the results of transrectal ultrasound and transrectal real-time elastography.
  
  
  RESULTS
  32/108 (29.6%) pts. were positive for prostate cancer (mean Gleason score 7.08), mean PSA 14 ng/mL and mean ratio 9.5%. Transrectal ultrasound scan shows a sensibility of 69% and specificity of 68%. Transrectal ultrasound scan shows a VPP of 51.4%. Transrectal ultrasound scan shows a VPN of 80.9%. Real-time elastography shows a sensibility of 56% and specificity of 85.7%. Real-time elastography shows a VPP of 60.1%. Real-time elastography shows a VPN of 83%.
  
  
  CONCLUSIONS
  Elastography has a significantly higher specificity for the detection of prostate cancer than the conventionally used examinations including DRE and TRUS. It is a useful real-time diagnostic method because it is not invasive, and simultaneous evaluation is possible while performing TRUS.
authors.affiliation: U.O. Urologia, Ospedale Gallarate (Varese), Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Romagnoli
authors.forename: Gaspare
authors.initials: G
authors.lastname: Autieri
authors.forename: Danilo
authors.initials: D
authors.lastname: Centrella
authors.forename: Christian
authors.initials: C
authors.lastname: Gastaldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pedaci
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rivolta
authors.forename: Emilio
authors.initials: E
authors.lastname: Pozzi
authors.forename: Alessio
authors.initials: A
authors.lastname: Anghileri
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cerabino
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Bianchi
authors.forename: Alberto
authors.initials: A
authors.lastname: Roggia
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D001707:Biopsy, Needle; D003199:Computer Systems; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen