Skip to main content
SpringerLink
Log in

Prostate cancer detection with real-time elastography using a bi-plane transducer: comparison with step section radical prostatectomy pathology

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate elastography using a bi-plane transducer for localizing prostate cancer (PCa) in patients scheduled for radical prostatectomy (RP), in comparison with step section pathological analysis.

Methods

Fifty-six consecutive PCa patients underwent real-time elastography examination with a bi-plane transducer before RP. Transverse elastographic images were obtained from the apex to the base by slightly compressing and releasing the prostate tissue using the probe. The diagnostic performance of elastography was evaluated in correlation with step section RP histopathology.

Results

In 56 PCa patients, gray-scale ultrasonography detected at least one lesion in 36 patients, whereas elastography detected at least one lesion in 53 patients (P = 0.001). The overall sensitivity, specificity and accuracy of elastography in depicting tumor lesions were 67.6, 89.5 and 82.7 %, respectively. The detection rate of a PCa lesion with elastography was best in the left posterior region, followed by the right posterior region. Elastography was more sensitive in detecting PCa lesions with higher Gleason scores, diameter >5 mm and extracapsular extension.

Conclusions

The additional use of elastography with the bi-plane transducer can improve PCa detection rate by providing more information about tissue stiffness within the prostate gland.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

PSA:

Prostate-specific antigen

DRE:

Digital rectal examination

PCa:

Prostate cancer

TRUS:

Transrectal ultrasound

RTE:

Real-time elastography

ROC:

Receiver operating characteristic

AUC:

Areas under the ROC curves

ECE:

Extracapsular extension

References

  1. Krouskop TA, Wheeler TM, Kallel F, Garra BS, Hall T (1998) Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging 20:260–274

    Article  CAS  PubMed  Google Scholar 

  2. Salomon G, Köllerman J, Thederan I, Chun FK, Budäus L, Schlomm T, Isbarn H, Heinzer H, Huland H, Graefen M (2008) Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy. Eur Urol 54:1354–1362

    Article  PubMed  Google Scholar 

  3. Pallwein L, Mitterberger M, Struve P, Pinggera G, Horninger W, Bartsch G, Aigner F, Lorenz A, Pedross F, Frauscher F (2007) Real-time elastography for detecting prostate cancer: preliminary experience. BJU Int 100:42–46

    Article  PubMed  Google Scholar 

  4. Sumura M, Shigeno K, Hyuga T, Yoneda T, Shiina H, Igawa M (2007) Initial evaluation of prostate cancer with real-time elastography based on step-section pathologic analysis after radical prostatectomy: a preliminary study. Int J Urol 14:811–816

    Article  PubMed  Google Scholar 

  5. Kamoi K, Okihara K, Ochiai A, Ukimura O, Mizutani Y, Kawauchi A, Miki T (2008) The utility of transrectal real-time elastography in the diagnosis of prostate cancer. Ultrasound Med Biol 34:1025–1032

    Article  PubMed  Google Scholar 

  6. Miyagawa T, Tsutsumi M, Matsumura T, Kawazoe N, Ishikawa S, Shimokama T, Miyanaga N, Akaza H (2009) Real-time elastography for the diagnosis of prostate cancer: evaluation of elastographic moving images. Jpn J Clin Oncol 39:394–398

    Article  PubMed  Google Scholar 

  7. Halpern EJ, Ramey JR, Strup SE, Frauscher F, McCue P, Gomella LG (2005) Detection of prostate carcinoma with contrast-enhanced sonography using intermittent harmonic imaging. Cancer 104:2373–2383

    Article  PubMed  Google Scholar 

  8. Bettendorf O, Oberpenning F, Köpke T, Heinecke A, Hertle L, Boecker W, Semjonow A (2007) Implementation of a map in radical prostatectomy specimen allows visual estimation of tumor volume. Eur J Surg Oncol 33:352–357

    Article  CAS  PubMed  Google Scholar 

  9. Gleason DF, Mellinger GT (1974) Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol 111:58–64

    CAS  PubMed  Google Scholar 

  10. Sobin LH (2003) TNM, sixth edition: new developments in general concepts and rules. Semin Surg Oncol 21:19–22

    Article  PubMed  Google Scholar 

  11. Scheidler J, Hricak H, Vigneron DB, Yu KK, Sokolov DL, Huang LR, Zaloudek CJ, Nelson SJ, Carroll PR, Kurhanewicz J (1999) Prostate cancer: localization with three-dimensional proton MR spectroscopic imaging–clinicopathologic study. Radiology 213:473–480

    Article  CAS  PubMed  Google Scholar 

  12. Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X (1991) Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 13:111–134

    CAS  PubMed  Google Scholar 

  13. Cochlin DL, Ganatra RH, Griffiths DF (2002) Elastography in the detection of prostatic cancer. Clin Radiol 57:1014–1020

    Article  PubMed  Google Scholar 

  14. Brock M, von Bodman C, Sommerer F, Löppenberg B, Klein T, Deix T, Palisaar JR, Noldus J, Eggert T (2011) 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. BJU Int 108:217–222

    Article  Google Scholar 

  15. Taylor LS, Rubens DJ, Porter BC, Wu Z, Baggs RB, di Sant’Agnese PA, Nadasdy G, Pasternack D, Messing EM, Nigwekar P, Parker KJ (2005) Prostate cancer: three-dimensional sonoelastography for in vitro detection. Radiology 237:981–985

    Article  PubMed  Google Scholar 

  16. Fujita K, Sugao H, Gotoh T, Yokomizo S, Itoh Y (2004) Primary signet ring cell carcinoma of the prostate: report and review of 42 cases. Int J Urol 11:178–181

    Article  PubMed  Google Scholar 

  17. Arista-Nasr J, Martinez-Benitez B, Fernandez-Amador JA, Bornstein-Quevedo L, Arceo-Olaiz R, Albores-Saavedra J (2011) Pseudohyperplastic prostatic carcinoma in simple prostatectomy. Ann Diagn Pathol 15:170–174

    Article  PubMed  Google Scholar 

  18. Muramaki M, Miyake H, Kurahashi T, Takenaka A, Fujisawa M (2010) Characterization of the anatomical extension pattern of localized prostate cancer arising in the peripheral zone. BJU Int 105:1514–1518

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a grant from Science and Technology Commission of Shanghai Municipality (10JC1411400, 10411952000, 09411963800, 09411950100).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Ultrasound in Medicine, Xinhua Hospital Affiliated to Shanghai, Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Yunkai Zhu, Yaqing Chen, Tingyue Qi & Jun Jiang

  2. Department of Urology, Xinhua Hospital Affiliated to Shanghai, Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Jun Qi & Yongjiang Yu

  3. Department of Pathology, Xinhua Hospital Affiliated to Shanghai, Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Xiaohong Yao & Wenbin Guan

Authors
  1. Yunkai Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yaqing Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tingyue Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jun Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yongjiang Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiaohong Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Wenbin Guan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yaqing Chen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhu, Y., Chen, Y., Qi, T. et al. Prostate cancer detection with real-time elastography using a bi-plane transducer: comparison with step section radical prostatectomy pathology. World J Urol 32, 329–333 (2014). https://doi.org/10.1007/s00345-012-0922-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-012-0922-1

Keywords

Search

Navigation