Potentials and limitations of real-time elastography for prostate cancer detection: a whole-mount step section analysis.
OBJECTIVE
To evaluate prostate cancer (PCa) detection rates of real-time elastography (RTE) in dependence of tumor size, tumor volume, localization and histological type.


METHODS
Thirdy-nine patients with biopsy proven PCa underwent RTE before radical prostatectomy (RPE) to assess prostate tissue elasticity, and hard lesions were considered suspicious for PCa. After RPE, the prostates were prepared as whole-mount step sections and were compared with imaging findings for analyzing PCa detection rates.


RESULTS
RTE detected 6/62 cancer lesions with a maximum diameter of 0-5 mm (9.7%), 10/37 with a maximum diameter of 6-10 mm (27%), 24/34 with a maximum diameter of 11-20 20 mm (70.6%), 14/14 with a maximum diameter of >20 mm (100%) and 40/48 with a volume ≥0.2 cm(3) (83.3%). Regarding cancer lesions with a volume ≥ 0.2 cm³ there was a significant difference in PCa detection rates between Gleason scores with predominant Gleason pattern 3 compared to those with predominant Gleason pattern 4 or 5 (75% versus 100%; P = 0.028).


CONCLUSIONS
RTE is able to detect PCa of significant tumor volume and of predominant Gleason pattern 4 or 5 with high confidence, but is of limited value in the detection of small cancer lesions.
Department of Radiology, Medical University of Innsbruck, Anichstraß 35, 6020 Innsbruck, Austria.
Daniel
D
Junker
Georg
G
Schäfer
Friedrich
F
Aigner
Peter
P
Schullian
Leo
L
Pallwein-Prettner
Jasmin
J
Bektic
Wolfgang
W
Horninger
Ethan J
EJ
Halpern
Ferdinand
F
Frauscher
D000368:Aged; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden