European Radiology

, Volume 27, Issue 5, pp 1858–1866 | Cite as

Stiffness of benign and malignant prostate tissue measured by shear-wave elastography: a preliminary study

  • Olivier Rouvière
  • Christelle Melodelima
  • Au Hoang Dinh
  • Flavie Bratan
  • Gaele Pagnoux
  • Thomas Sanzalone
  • Sébastien Crouzet
  • Marc Colombel
  • Florence Mège-Lechevallier
  • Rémi Souchon



To measure benign and malignant prostate tissue stiffness using shear-wave elastography (SWE).


Thirty consecutive patients underwent transrectal SWE in the axial and sagittal planes before prostatectomy. After reviewing prostatectomy specimens, two radiologists measured stiffness in regions corresponding to cancers, lateral and median benign peripheral zone (PZ) and benign transition zone (TZ).


Cancers were stiffer than benign PZ and TZ. All tissue classes were stiffer on sagittal than on axial imaging, in TZ than in PZ, and in median PZ than in lateral PZ. At multivariate analysis, the nature of tissue (benign or malignant; P < 0.00001), the imaging plane (axial or sagittal; P < 0.00001) and the location within the prostate (TZ, median PZ or lateral PZ; P = 0.0065) significantly and independently influenced tissue stiffness. On axial images, the thresholds maximising the Youden index in TZ, lateral PZ and median PZ were respectively 62 kPa, 33 kPa and 49 kPa. On sagittal images, the thresholds were 76 kPa, 50 kPa and 72 kPa, respectively.


SWE can distinguish prostate malignant and benign tissues. Tissue stiffness is influenced by the imaging plane and the location within the gland.

Key Points

Prostate cancers were stiffer than the benign peripheral zone

All tissue classes were stiffer on sagittal than on axial imaging

All tissue classes were stiffer in the transition zone than in the peripheral zone

All tissue classes were stiffer in the median than in the lateral peripheral zone

Taking into account imaging plane and zonal anatomy can improve cancer detection


Prostatic neoplasms Elasticity imaging techniques Ultrasound Shear waves Prostatectomy 



Shear-wave elastography


Peripheral zone


Transition zone


Benign prostate hyperplasia



The scientific guarantor of this publication is Olivier Rouvière. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by a grant from the French National Cancer Institute (Institut National du Cancer; Cartographix project—PAIR Prostate funding programme). One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, diagnostic or prognostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Olivier Rouvière
    • 1
    • 2
    • 3
    • 4
  • Christelle Melodelima
    • 5
    • 6
  • Au Hoang Dinh
    • 4
  • Flavie Bratan
    • 1
    • 2
    • 3
    • 4
  • Gaele Pagnoux
    • 1
  • Thomas Sanzalone
    • 1
    • 2
    • 3
  • Sébastien Crouzet
    • 2
    • 3
    • 4
    • 7
  • Marc Colombel
    • 2
    • 3
    • 7
  • Florence Mège-Lechevallier
    • 8
  • Rémi Souchon
    • 4
  1. 1.Hospices Civils de Lyon, Department of Urinary and Vascular RadiologyHôpital Edouard HerriotLyonFrance
  2. 2.Université de LyonLyonFrance
  3. 3.Université Lyon 1, Faculté de Médecine Lyon EstLyonFrance
  4. 4.Inserm, U1032, LabTauLyonFrance
  5. 5.Université Joseph Fourier, Laboratoire d’Ecologie Alpine, BP 53GrenobleFrance
  6. 6.CNRS, UMR 5553, BP 53GrenobleFrance
  7. 7.Hospices Civils de Lyon, Department of UrologyHôpital Edouard HerriotLyonFrance
  8. 8.Hospices Civils de Lyon, Department of PathologyHôpital Edouard HerriotLyonFrance

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