International Journal of Clinical Oncology

, Volume 12, Issue 4, pp 250–255

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

  • Masakazu Tsutsumi
  • Tomoaki Miyagawa
  • Takeshi Matsumura
  • Natsui Kawazoe
  • Satoru Ishikawa
  • Tatsuro Shimokama
  • Tsuyoshi Shiina
  • Naoto Miyanaga
  • Hideyuki Akaza
ORIGINAL ARTICLE

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 

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References

  1. 1.
    Shiina T, Doyley MM, Bamber JC (1996) Strain imaging using combined RF and envelope autocorrelation processing. In: Proceedings of 1996 IEEE Ultrasonics Symposium. Piscataway, N.J. USA. pp 1331–1336Google Scholar
  2. 2.
    Matsumura T, Tamano S, Shinomura R, et al. (2004) Diagnostic results for breast disease by real-time elasticity imaging system. In: Proceedings of 2004 IEEE Ultrasonics Symposium. Piscataway, N.J. USA. pp 1484–1487Google Scholar
  3. 3.
    Itoh, A, Ueno, E, Tohno, E,  et al. 2006Breast disease: clinical application of US elastography for diagnosisRadiology239341350PubMedCrossRefGoogle Scholar
  4. 4.
    Cochlin, DL, Ganatra, RH, Griffiths, D 2002Elastography in the detection of prostatic cancerClin Radiol1110141020CrossRefGoogle Scholar
  5. 5.
    Konig, K, Scheipers, U, Pesavento, A,  et al. 2005Initial experiences with real-time elastography guided biopsies of the prostateJ Urol174115117PubMedCrossRefGoogle Scholar
  6. 6.
    Miyanaga, N, Akaza, H, Yamakawa, M,  et al. 2006Tissue elasticity imaging for diagnosis of prostate cancer: a preliminary reportInt J Urol1315141518PubMedCrossRefGoogle Scholar
  7. 7.
    Shinohara, K, Wheeler, TM, Scardino, PT 1989The appearance of prostate cancer on transrectal ultrasonography: correlation of imaging and pathological examinationsJ Urol1427682PubMedGoogle Scholar
  8. 8.
    Frauscher, F, Klauser, A, Halpern, EJ,  et al. 2001Detection of prostate cancer with a microbubble ultrasound contrast agentLancet35718491850PubMedCrossRefGoogle Scholar
  9. 9.
    Mullerad, M, Hricak, H, Kuroiwa, K,  et al. 2005Comparison of endorectal magnetic resonance imaging, guided prostate biopsy and digital rectal examination in the preoperative anatomical localization of prostate cancerJ Urol17421582163PubMedCrossRefGoogle Scholar
  10. 10.
    Sala, E, Eberhardt, SC, Akin, O,  et al. 2006Endorectal MR imaging before salvage prostatectomy: tumor localization and stagingRadiology238176183PubMedCrossRefGoogle Scholar
  11. 11.
    Wang, L, Hricak, H, Kattan, MW,  et al. 2006Prediction of organ-confined prostate cancer: incremental value of MR imaging and MR spectroscopic imaging to staging nomogramsRadiology238597603PubMedCrossRefGoogle Scholar
  12. 12.
    Hricak, H 2005MR imaging and MR spectroscopic imaging in the pre-treatment evaluation of prostate cancerBr J Radiol78S103S111PubMedCrossRefGoogle Scholar
  13. 13.
    Lee, F,Jr, Bronson, JP, Lerner, RM,  et al. 1991Sonoelasticity imaging: results in in vitro tissue specimensRadiology181237239PubMedGoogle Scholar
  14. 14.
    Smith, DS, Catalona, WJ 1994The nature of prostate cancer detected through prostate specific antigen based screeningJ Urol15217321736PubMedGoogle Scholar
  15. 15.
    Obek, C, Louis, P, Civantos, F,  et al. 1999Comparison of digital rectal examination and biopsy results with the radical prostatectomy specimenJ Urol161494498PubMedCrossRefGoogle Scholar
  16. 16.
    Takashima, R, Egawa, S, Kuwao, S,  et al. 2002Anterior distribution of stage T1c nonpalpable tumors in radical prostatectomy specimensUrology59692697PubMedCrossRefGoogle Scholar
  17. 17.
    Debras, B, Guillonneau, B, Bougaran, J,  et al. 1998Prognostic significance of seminal vesicle invasion on the radical prostatectomy specimen. Rationale for seminal vesicle biopsiesEur Urol33271277PubMedCrossRefGoogle Scholar
  18. 18.
    Hull, GW, Rabbani, F, Abbas, F,  et al. 2002Cancer control with radical prostatectomy alone in 1000 consecutive patientsJ Urol167528534PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Society of Clinical Oncology 2007

Authors and Affiliations

  • Masakazu Tsutsumi
    • 1
  • Tomoaki Miyagawa
    • 2
  • Takeshi Matsumura
    • 3
  • Natsui Kawazoe
    • 4
  • Satoru Ishikawa
    • 1
  • Tatsuro Shimokama
    • 5
  • Tsuyoshi Shiina
    • 6
  • Naoto Miyanaga
    • 4
  • Hideyuki Akaza
    • 4
  1. 1.Department of UrologyHitachi General HospitalIbarakiJapan
  2. 2.Department of UrologyKitaibaraki Municipal HospitalKitaibarakiJapan
  3. 3.Research and Development CenterHitachi Medical CorporationKashiwaJapan
  4. 4.Department of UrologyUniversity of TsukubaTsukubaJapan
  5. 5.Department of PathologyHitachi General HospitalHitachiJapan
  6. 6.Institute of Systems and Information EngineeringUniversity of TsukubaTsukubaJapan

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