Abstract
The lack of reliable imaging tools in detecting prostate cancer makes a random biopsy still the standard of care to detect prostate cancer. To reduce the number of cores during a biopsy and therefore the risk of biopsy-related complications, an imaging tool which provides reliable guided biopsies is required. Transrectal real-time elastography has shown to have the ability to visualize prostate cancer foci to some extent. In addition to the conventional B-mode image of transrectal ultrasound, it adds information about the stiffness of the prostate tissue. This review highlights the most important studies on elastography to follow the improvements in techniques and to outline the ability to detect prostate cancer and guide biopsies.
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Ophir J, Cespedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging. 1991;13(2):111–34.
Pallwein L, Mitterberger M, Gradl J, Aigner F, Horninger W, Strasser H, et al. Value of contrast-enhanced ultrasound and elastography in imaging of prostate cancer. Curr Opin Urol. 2007;17(1):39–47. doi:10.1097/MOU.0b013e328011b85c.
Walz J, Marcy M, Pianna JT, Brunelle S, Gravis G, Salem N, et al. Identification of the prostate cancer index lesion by real-time elastography: considerations for focal therapy of prostate cancer. World J Urol. 2011;29(5):589–94. doi:10.1007/s00345-011-0688-x.
Salomon G, Kollerman J, Thederan I, Chun FK, Budaus L, Schlomm T, et al. Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy. Eur Urol. 2008;54(6):1354–62. doi:10.1016/j.eururo.2008.02.035.
Pallwein L, Mitterberger M, Struve P, Pinggera G, Horninger W, Bartsch G, et al. Real-time elastography for detecting prostate cancer: preliminary experience. BJU Int. 2007;100(1):42–6. doi:10.1111/j.1464-410X.2007.06851.x.
Sumura M, Shigeno K, Hyuga T, Yoneda T, Shiina H, Igawa M. Initial evaluation of prostate cancer with real-time elastography based on step-section pathologic analysis after radical prostatectomy: a preliminary study. Int J Urol. 2007;14(9):811–6. doi:10.1111/j.1442-2042.2007.01829.x.
Tsutsumi M, Miyagawa T, Matsumura T, Endo T, Kandori S, Shimokama T, et al. Real-time balloon inflation elastography for prostate cancer detection and initial evaluation of clinicopathologic analysis. AJR Am J Roentgenol. 2010;194(6):W471–6. doi:10.2214/AJR.09.3301.
Brock M, Eggert T, Palisaar RJ, Roghmann F, Braun K, Loppenberg B, et al. Multiparametric ultrasound of the prostate: adding contrast enhanced ultrasound to real-time elastography to detect histopathologically confirmed cancer. J Urol. 2013;189(1):93–8. doi:10.1016/j.juro.2012.08.183.
Junker D, Schafer G, Aigner F, Schullian P, Pallwein-Prettner L, Bektic J, et al. Potentials and limitations of real-time elastography for prostate cancer detection: a whole-mount step section analysis. Sci World J. 2012;2012:193213. doi:10.1100/2012/193213.
Rausch S, Alt W, Arps H, Alt B, Kalble T. The utility of transrectal sonoelastography in preoperative prostate cancer assessment. Med Ultrason. 2012;14(3):182–6.
Zhu Y, Chen Y, Qi T, Jiang J, Qi J, Yu Y, et al. Prostate cancer detection with real-time elastography using a bi-plane transducer: comparison with step-section radical prostatectomy pathology. World J Urol. 2012. doi:10.1007/s00345-012-0922-1.
Tsutsumi M, Miyagawa T, Matsumura T, Kawazoe N, Ishikawa S, Shimokama T, et al. The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis. Int J Clin Oncol. 2007;12(4):250–5. doi:10.1007/s10147-007-0669-7.
Zhang Y, Tang J, Li YM, Fei X, He EH, Li QY, et al. The contribution of strain patterns in characterization of prostate peripheral zone lesions at transrectal ultrasonography. Acta Radiol. 2012;53(1):119–26. doi:10.1258/ar.2011.110504.
Draisma G, Etzioni R, Tsodikov A, Mariotto A, Wever E, Gulati R, et al. Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context. J Natl Cancer Inst. 2009;101(6):374–83. doi:10.1093/jnci/djp001.
Pallwein L, Mitterberger M, Pinggera G, Aigner F, Pedross F, Gradl J, et al. Sonoelastography of the prostate: comparison with systematic biopsy findings in 492 patients. Eur J Radiol. 2008;65(2):304–10. doi:10.1016/j.ejrad.2007.03.032.
Ferrari FS, Scorzelli A, Megliola A, Drudi FM, Trovarelli S, Ponchietti R. Real-time elastography in the diagnosis of prostate tumor. J Ultrasound. 2009;12(1):22–31. doi:10.1016/j.jus.2009.01.001.
Miyagawa T, Tsutsumi M, Matsumura T, Kawazoe N, Ishikawa S, Shimokama T, et al. Real-time elastography for the diagnosis of prostate cancer: evaluation of elastographic moving images. Jpn J Clin Oncol. 2009;39(6):394–8. doi:10.1093/jjco/hyp026.
Giurgiu CR, Manea C, Crisan N, Bungardean C, Coman I, Dudea SM. Real-time sonoelastography in the diagnosis of prostate cancer. Med Ultrason. 2011;13(1):5–9.
Konig K, Scheipers U, Pesavento A, Lorenz A, Ermert H, Senge T. Initial experiences with real-time elastography guided biopsies of the prostate. J Urol. 2005;174(1):115–7. doi:10.1097/01.ju.0000162043.72294.4a.
Eggert T, Khaled W, Wenske S, Ermert H, Noldus J. Impact of elastography in clinical diagnosis of prostate cancer. A comparison of cancer detection between B-mode sonography and elastography-guided 10-core biopsies. Urologe A. 2008;47(9):1212–7.
Aigner F, Pallwein L, Junker D, Schafer G, Mikuz G, Pedross F, et al. Value of real-time elastography targeted biopsy for prostate cancer detection in men with prostate-specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less. J Urol. 2010;184(3):913–7.
Aigner F, Pallwein L, Schocke M, Lebovici A, Junker D, Schafer G, et al. Comparison of real-time sonoelastography with T2-weighted endorectal magnetic resonance imaging for prostate cancer detection. J Ultrasound Med. 2011;30(5):643–9.
Aigner F, Schafer G, Steiner E, Jaschke W, Horninger W, Herrmann TR, et al. Value of enhanced transrectal ultrasound targeted biopsy for prostate cancer diagnosis: a retrospective data analysis. World J Urol. 2012;30(3):341–6. doi:10.1007/s00345-011-0809-6.
Ganzer R, Brandtner A, Wieland WF, Fritsche HM. Prospective blinded comparison of real-time sonoelastography targeted versus randomised biopsy of the prostate in the primary and re-biopsy setting. World J Urol. 2012;30(2):219–23. doi:10.1007/s00345-011-0679-y.
Kapoor A, Mahajan G, Sidhu BS. Real-time elastography in the detection of prostate cancer in patients with raised PSA level. Ultrasound Med Biol. 2011;37(9):1374–81. doi:10.1016/j.ultrasmedbio.2011.05.014.
Taverna G, Magnoni P, Giusti G, Seveso M, Benetti A, Hurle R, et al. Impact of real-time elastography versus systematic prostate biopsy method on cancer detection rate in men with a serum prostate-specific antigen between 2.5 and 10 ng/mL. ISRN. Oncol. 2013;2013:584672.
Kamoi K, Okihara K, Ochiai A, Ukimura O, Mizutani Y, Kawauchi A, et al. The utility of transrectal real-time elastography in the diagnosis of prostate cancer. Ultrasound Med Biol. 2008;34(7):1025–32. doi:10.1016/j.ultrasmedbio.2007.12.002.
Nelson ED, Slotoroff CB, Gomella LG, Halpern EJ. Targeted biopsy of the prostate: the impact of color Doppler imaging and elastography on prostate cancer detection and Gleason score. Urology. 2007;70(6):1136–40. doi:10.1016/j.urology.2007.07.067.
Pallwein L, Mitterberger M, Struve P, Horninger W, Aigner F, Bartsch G, et al. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection. Eur Radiol. 2007;17(9):2278–85. doi:10.1007/s00330-007-0606-1.
Salomon G, Drews N, Autier P, Beckmann A, Heinzer H, Hansen J, et al. Incremental detection rate of prostate cancer by HI-real time elastography targeted biopsies in combination to a conventional 10 core biopsy in 1024 consecutive men. BJU Int. 2013. doi:10.1111/bju.12517.
Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006;239(2):341–50. doi:10.1148/radiol.2391041676.
Salomon GBL. 799 Subjective risk assessment for the diagnosis of prostate cancer using real-time elastography (RTE) prior to biopsy and assessment of real-time elastography for prostate cancer detection by comparing RTE-based and grey scale ultrasound biopsies. Eur Urol Suppl. 2012;11(1):e799. doi:10.1016/S1569-9056(12)60796-9.
Pelzer AE, Heinzelbecker J, Weiss C, Fruhbauer D, Weidner AM, Kirchner M, et al. Real-time sonoelastography compared to magnetic resonance imaging using four different modalities at 3.0 T in the detection of prostate cancer: strength and weaknesses. Eur J Radiol. 2013;82(5):814–21.
Moore CM, Kasivisvanathan V, Eggener S, Emberton M, Futterer JJ, Gill IS, et al. Standards of reporting for MRI-targeted biopsy studies (START) of the prostate: recommendations from an International Working Group. Eur Urol. 2013;64(4):544–52. doi:10.1016/j.eururo.2013.03.030.
Barr RG, Memo R, Schaub CR. Shear wave ultrasound elastography of the prostate: initial results. Ultrasound Q. 2012;28(1):13–20. doi:10.1097/RUQ.0b013e318249f594.
Ahmad S, Cao R, Varghese T, Bidaut L, Nabi G. Transrectal quantitative shear wave elastography in the detection and characterisation of prostate cancer. Surg Endosc. 2013;27(9):3280–7. doi:10.1007/s00464-013-2906-7.
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Dr. Georg Salomon and Dr. Jonas Schiffmann each declare no potential conflicts of interest relevant to this article.
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Salomon, G., Schiffmann, J. Real-Time Elastography for the Detection of Prostate Cancer. Curr Urol Rep 15, 392 (2014). https://doi.org/10.1007/s11934-013-0392-z
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DOI: https://doi.org/10.1007/s11934-013-0392-z