ORIGINAL ARTICLE

International Journal of Clinical Oncology

, Volume 12, Issue 4, pp 250-255

First online:

The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis

  • Masakazu TsutsumiAffiliated withDepartment of Urology, Hitachi General Hospital Email author 
  • , Tomoaki MiyagawaAffiliated withDepartment of Urology, Kitaibaraki Municipal Hospital
  • , Takeshi MatsumuraAffiliated withResearch and Development Center, Hitachi Medical Corporation
  • , Natsui KawazoeAffiliated withDepartment of Urology, University of Tsukuba
  • , Satoru IshikawaAffiliated withDepartment of Urology, Hitachi General Hospital
  • , Tatsuro ShimokamaAffiliated withDepartment of Pathology, Hitachi General Hospital
  • , Tsuyoshi ShiinaAffiliated withInstitute of Systems and Information Engineering, University of Tsukuba
  • , Naoto MiyanagaAffiliated withDepartment of Urology, University of Tsukuba
  • , Hideyuki AkazaAffiliated withDepartment of Urology, University of Tsukuba

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Abstract

Background

We evaluated the accuracy and feasibility of real-time elastography for detecting prostate cancer, using prostatectomy specimens.

Methods

This study was based on clinicopathological findings in 51 patients with prostate cancer who were referred for elastography at the time of prostate biopsy. We compared transverse pathology sections with elastographic moving images (EMIs) to determine the detection rate of cancer, the relationship between tumor location and the elastographic findings, and the relationship between the Gleason score and the elastographic findings.

Results

In 15 patients (29%), all EMIs were in complete agreement with tumor location (category I), in 28 patients (55%), the EMIs agreed with tumor location, but showed some disagreement (category II), and in 8 patients (16%) there was disagreement of the elastographic findings with tumor location or the tumors were undetectable by elastography (category III). However, in category III, all tumors were detected as low-echoic by B-mode ultrasonography. We divided the prostate into three different regions (anterior, middle, and posterior), and found that 30/32 (94%) anterior tumors, 13/17 (76%) middle tumors, and 16/28 (57%) posterior tumors were detected by elastography. The proportions of cancers detected by elastography (categories I+II/total) was 100% in the patients with a Gleason score of 6, 85% in those with a score of 7 or 8, and 63% in those with a score of 9 or 10.

Conclusion

Real-time elastography in conjunction with B-mode ultrasonography significantly improves the detection of prostate cancer. One of the characteristic findings of elastography is its excellent detection of anterior tumors. The low detection rate of high-grade tumors in this analysis was likely due to the predominance of high-grade tumors in a peripheral location compared to the anterior location of the low-grade tumors.

Key words

Prostate cancer Diagnosis Ultrasonography Elastography Pathology