Purpose: This study aims to evaluate the value of quantitative analysis of ultrasound real-time tissue diffusion elastography in the diagnosis of benign and malignant prostate lesions.
Materials and Methods: From March 2010 to June 2013, 52 patients suspected with prostate cancer based on laboratory or clinical test results and underwent prostate biopsy in our hospital were enrolled into this study. The age of these patients ranged between 45-82 years, with an average age of 67.2 ± 6.8 years. All patients underwent transrectal real-time ultrasound elastography (TRTE) before biopsy. A total of 63 prostate nodules were detected, and the 11 elastic characteristic quantities of these nodules were quantitatively analyzed via tissue diffusion quantitative analysis. The results of ultrasonography were compared with the results of operation and pathology.
Result: Among these 11 characteristic quantities, which include the mean (MEAN) and standard deviation (SD), blue area ratio (AREA%), complexity (COMP), kurtosis (KURT), skewness (SKEW), contrast (CONT), equality (ENT), entropy (IDM), consistency (ASM) and correlation (CORR), except for COMP and CORR, the differences in other nine characteristic quantities between benign and malignant prostatic nodules were statistically significant (P<0.05). Among these, the AREA% and MEAN had the highest correlation, which were 0.791 and -0.791, respectively. The Youden’s index (sensitivity and specificity) of AREA% in the ROC curves was the highest, the cutoff value was 80.65% for the diagnosis of prostate cancer, sensitivity was 87.9%, and specificity was 96.6%.
Conclusion: Quantitative analysis of ultrasound real-time tissue diffusion elastography is helpful in the diagnosis of benign and malignant prostate lesions, provides a relatively accurate evaluation method in clinical practice, and has broad application prospects.
Nygård Y, Haukaas SA, Halvorsen OJ, Gravdal K, Frugård J, Akslen LA et al. A positive Real-Time Elastography (RTE) combined with a Prostate Cancer Gene 3 (PCA3) score above 35 convey a high probability of intermediate- or high-risk prostate cancer in patient admitted for primary prostate biopsy[J]. BMC Urology, 2016, 16(1):1-8.
Heidenreich A, Bastian PJ, Bellmunt J, Bollad M, Joniaue S, Masong M, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013[J]. European urology, 2014, 65(1): 124-137.
Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJJ,et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer[J]. New England Journal of Medicine, 1991, 324(17): 1156-1161.
Walz J, Loch T, Salomon G, Wijkstra H. [Imaging of the prostate][J]. Der Urologe. Ausg. A, 2013, 52(4): 490-496.
Brock M, Eggert T, Palisaar RJ, Roghmann F, Braun K, Löppenberg B, et al. Multiparametric ultrasound of the prostate: adding contrast enhanced ultrasound to real-time elastography to detect histopathologically confirmed cancer[J]. The Journal of urology, 2013, 189(1): 93-98.
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[J]. Ultrasound in medicine & biology, 2008, 34(7): 1025-1032.
Porsch M, Wendler JJ, Liehr UB, Lux A, Schostak M and Pech M. New aspects in shear-wave elastography of prostate cancer[J]. Journal of Ultrasonography, 2015, 15(60): 5.
Tatsumi C, Kudo M, Ueshima K, Kitai S, Ishikawa E, Yada N, et al. Non-invasive evaluation of hepatic fibrosis for type C chronic hepatitis[J]. Intervirology, 2010, 53(1): 76-81.
Brock M, Sommerer F, Löppenberg B, Klein T, Deix T, Palisaar JR, et al. Comparison of real-time elastography with grey-scale ultrasonography for detection of organ-confined prostate cancer and extra capsular extension: a prospective analysis using whole mount sections after radical prostatectomy[J]. BJU international, 2011, 108(8b): E217-E222.
Walz J, Marcy M, Maubon T, Brunelle S, Laroche J, Gravis G,et al. [Real time elastography in the diagnosis of prostate cancer: comparison of preoperative imaging and histology after radical prostatectomy][J]. Progres en urologie: journal de l'Association francaise d'urologie et de la Societe francaise d'urologie, 2011, 21(13): 925-931.
Salomon G, Köllerman J, Thederan I, Budäus L, Schlomm T, Isbarn H, et al. Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy[J]. European urology, 2008, 54(6): 1354-1362.
Brock M, Eggert T, Palisaar RJ, Roghmann F, Braun K, Löppenberg B, et al. Multiparametric ultrasound of the prostate: adding contrast enhanced ultrasound to real-time elastography to detect histopathologically confirmed cancer. J Urology 2013; 189: 93-98.