Stiffness of benign and malignant prostate tissue measured by shear-wave elastography: a preliminary study
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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.
• 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
KeywordsProstatic neoplasms Elasticity imaging techniques Ultrasound Shear waves Prostatectomy
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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