title: Prediction of Significant Prostate Cancer at Prostate Biopsy and Per Core Detection Rate of Targeted and Systematic Biopsies Using Real-Time Shear Wave Elastography.
abstract: BACKGROUND
  Prostate cancer (PCa) detection is accompanied by overdiagnosis and mischaracterization of PCa. Therefore, new imaging modalities like shear wave elastography (SWE) are required.
  
  
  OBJECTIVE
  The aim of this study was to evaluate per-core detection rates (DRs) of targeted biopsies and systematic biopsies and to test if SWE findings can predict presence of clinically significant PCa (csPCa) at biopsy.
  
  
  METHODS
  Overall, 95 patients scheduled for prostate biopsy in our center underwent SWE. SWE findings were classified into suspicious or normal. Targeted biopsies were taken in up to 3 SWE-suspicious areas. csPCa was defined as the presence of Gleason pattern ≥4, level of prostate-specific antigen ≥10 ng/ml or >2 positive cores.
  
  
  RESULTS
  Overall DR for csPCa in our study cohort was 40%. Per-core DR for exclusively SWE-targeted cores versus systematic samples cores was 10.5 vs. 8.6% (p = 0.3). In the logistic regression models, individuals with suspicious SWE findings are at 6.4-fold higher risk of harboring csPCa (p = 0.03). Gain in predictive accuracy was 2.3% (0.82 vs. 0.84, p = 0.01).
  
  
  CONCLUSIONS
  Presence of suspicious SWE findings is an independent predictor of csPCa. Therefore, SWE may be helpful in selecting patients for biopsy. Nonetheless, per-core DR for SWE-targeted cores was not statistically significant higher than DR of systematic sampled cores. Therefore, additional systematic biopsy is mandatory.
authors.affiliation: Martini-Clinic, Prostate Cancer Centre, Hamburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Boehm
authors.forename: Lars
authors.initials: L
authors.lastname: Budäus
authors.forename: Pierre
authors.initials: P
authors.lastname: Tennstedt
authors.forename: Burkhard
authors.initials: B
authors.lastname: Beyer
authors.forename: Jonas
authors.initials: J
authors.lastname: Schiffmann
authors.forename: Alessandro
authors.initials: A
authors.lastname: Larcher
authors.forename: Kathrin
authors.initials: K
authors.lastname: Simonis
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Dirk
authors.initials: D
authors.lastname: Beyersdorff
authors.forename: Georg
authors.initials: G
authors.lastname: Salomon
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D012044:Regression Analysis
chemical_list: D017430:Prostate-Specific Antigen