title: Identification of the prostate cancer index lesion by real-time elastography: considerations for focal therapy of prostate cancer.
abstract: BACKGROUND
  Focal therapy of prostate cancer is gaining more and more interest. One of the drawbacks of focal therapy of prostate cancer is the problem of correct identification of prostate cancer lesions. The aim of the study was to evaluate the ability of real-time elastography to correctly identify the prostate cancer index lesion.
  
  
  METHODS
  In 32 patients, real-time elastography was performed the day before prostatectomy. During the examination, the location of the main lesion suspicious for prostate cancer was prospectively recorded. Moreover, the results of the randomized multicore biopsies were also used to predict the location of the index lesion. The preoperative elastography results, the biopsy results, and a combined use of elastography and biopsy results were then compared with the pathological results to calculate the diagnostic values for correct index lesion identification.
  
  
  RESULTS
  When using real-time elastography alone to identify the prostate cancer index lesion, sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were 58.8, 43.3, 54.1, 48.1, and 51.6%, respectively. Data from randomized biopsies alone achieved 67.8, 48.4, 56.8, 60.0, and 58.1%, respectively. The combination of elastography and biopsy data increased the values to, respectively, 84.9, 48.4, 61.9, 75.0, and 66.1%.
  
  
  CONCLUSIONS
  In this study, real-time elastography alone did not allow to identify the prostate cancer index lesion with satisfactory reliability. The combination of real-time elastography and data from randomized 12 core biopsies allows promising ability to correctly identify the prostate cancer index lesion.
authors: Department of Urology, Institut Paoli-Calmettes, 232, Boulevard Ste. Marguerite/B.P.: 156, 13273 Marseille, France. walzj@marseille.fnclcc.fr
authors: Jochen
authors: J
authors: Walz
authors: Myriam
authors: M
authors: Marcy
authors: Jeanne Thomassin
authors: JT
authors: Pianna
authors: Serge
authors: S
authors: Brunelle
authors: Gwenaelle
authors: G
authors: Gravis
authors: Naji
authors: N
authors: Salem
authors: Franck
authors: F
authors: Bladou
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