title: Comparison of real-time elastography with grey-scale ultrasonography for detection of organ-confined prostate cancer and extra capsular extension: a prospective analysis using whole mount sections after radical prostatectomy.
abstract: OBJECTIVE
  •To evaluate whether transrectal real-time elastography (RTE) improves the detection of intraprostatic prostate cancer (PCa) lesions and extracapsular extension (ECE) compared with conventional grey-scale ultrasonography (GSU).
  
  
  METHODS
  •In total, 229 patients with biopsy-proven PCa were prospectively screened for cancer-suspicious areas and ECE using GSU and RTE. •The largest tumour focus detected by RTE was defined as the index lesion. •The prostate gland was stratified into six sectors on GSU and RTE, which were compared with histopathological whole mount sections after radical prostatectomy.
  
  
  RESULTS
  •Histopathologically, PCa was confirmed in 894 out of 1374 (61.8%) evaluated sectors and ECE was identified in 47 (21%) patients. •Of these 894 sectors, RTE correctly detected 594 (66.4%) and GSU 215 (24.0%) cancer suspicious lesions. •Sensitivity was 51% and specificity 72% using RTE compared to 18% and 90% for GSU. •RTE identified the largest side specific tumour focus in 68% of patients. •ECE was identified with a sensitivity of 38% and specificity of 96% using RTE compared to 15% and 97% using GSU.
  
  
  CONCLUSIONS
  •Compared with GSU, RTE provides a statistically significant improvement in detection of PCa lesions and ECE. •RTE enhances GSU, although improvement is still needed to achieve a clinically meaningful sensitivity.
authors.affiliation: Department of Urology, Ruhr-Universität Bochum, Marienhospital Herne, Widumer Strsee 8, 44627 Herne, Germany. marko.brock@marienhospitalherne.de
authors.forename: Marko
authors.initials: M
authors.lastname: Brock
authors.forename: Christian
authors.initials: C
authors.lastname: von Bodman
authors.forename: Florian
authors.initials: F
authors.lastname: Sommerer
authors.forename: Björn
authors.initials: B
authors.lastname: Löppenberg
authors.forename: Tobias
authors.initials: T
authors.lastname: Klein
authors.forename: Thomas
authors.initials: T
authors.lastname: Deix
authors.forename: Jüri Rein
authors.initials: JR
authors.lastname: Palisaar
authors.forename: Joachim
authors.initials: J
authors.lastname: Noldus
authors.forename: Thilo
authors.initials: T
authors.lastname: Eggert
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery