Shear Wave Elastography in Aggressive Prostate Cancer Assessment (Preliminary Results)

Analysis of shear wave elastography results was done in 97 patients with prostate cancer diagnosis aged from 51 up to 78 years old. All patients had positive results of targeted biopsy (lesions which were visualized during multiparametric transrectal ultrasound) which was included in extended transrectal systematic biopsy with separate core labeling. Patients were divided in to the groups according to Gleason score value. Ultrasound was done using Aixplorer scanner (Supersonic Imagine, France) equipped with intracavitary convex probe (3-12 MHz). There was a significant difference between Young’s modulus in groups with different Gleason score (5, 6, 7, 8, 9 and 10) (P < 0.000). Significant difference (P < 0.000) was between Young’s modulus in subgroups with Gleason score <8 and ≥8, <7 and ≥7. Emean in subgroup with Gleason score <8 was 94.0 (56.7-188.8) kPa (median, 5-95th percentiles), in subgroup with Gleason score ≥8 - 184.7 (77.7-296.8) kPa; Emax - 100.0 (66.8-215.9) and 271.7 (87.5-300.0) kPa respectively. Emean in subgroup with Gleason score <7 was 85.3 (53.9-137.4) kPa, in subgroup with Gleason score ≥7 - 92.2 (64.6-150.4) kPa; Emax - 150.0 (78.0-296.1) and 170.6 (82.2-300.0) kPa respectively. There were significant correlations between Gleason score and Emean (r _S = 0.69, t _k = 0.54), Gleason score and Emax (r _S = 0.69, t _k = 0.55) (P < 0.000 for all correlations). Cut-off values of Emean 110.0 kPa and Emax 150.7 kPa allowed to predict aggressive prostate cancer (Gleason score ≥8) with sensitivity 89.7 and 75.9%, specificity 67.6 and 82.4% respectively. Cutoff va lues of Emean 106.3 kPa and Emax 134.0 kPa allowed to predict Gleason score ≥7 with sensitivity 76.4 and 72.7%, specificity 83.3 and 88.1% respectively. 100% specificity was found out for cut-off values 141.0 kPa (Emean) and 170.0 kPa (Emax) for prediction of Gleason score ≥7 with 50.9% sensitivity (for both). However all these cut-off values are not for routine use, particularly due to selection criteria (prostate cancer with focal changes on multiparametric transrectal ultrasound).

1. Митьков В.В., Васильева А.К., Митькова М.Д. Диагностическая информативность ультразвуковой эластографии сдвиговой волной в диагностике рака предстательной железы // Ультразвуковая и функциональная диагностика. 2013. № 5. С.30-43.

2. Postema A., Mischi M., de la Rosette J., Wijkstra H. Multiparametric ultrasound in the detection of prostate cancer: a systematic review // World J. Urol. 2015. Epub ahead of print. Режим доступа: http://www.ncbi.nlm.nih.gov/pubmed/25761736.

3. Mottet N., Bellmunt J., Briers E. et al. Guidelines on Prostate Cancer / European Association of Urology Guidelines. 2015 edition. Режим доступа: http://uroweb.org/wp-content/uploads/EAU- Guidelines-Prostate-Cancer-2015-v2.pdf.

4. Cosgrove D., Piscaglia F., Bamber J. et al. EFSUMB guidelines and recommendations on the clinical use5of ultrasound elastography. Part 2: Clinical applications // Ultraschall Med. 2013. V. 34. № 3. P.238-253.

5. Barr R.G., Memo R., Schaub C.R. Shear wave ultrasound elastography of the prostate: initial results // Ultrasound Q. 2012. V. 28. № 1. P. 13-20.

6. Ahmad S., Cao R., Varghese T. et al. Transrectal quantitative shear wave elastography in the detection and characterisation of prostate cancer // Surg. Endosc. 2013. V. 27. № 9. P. 3280-3287.

7. Woo S., Kim S.Y., Cho J.Y., Kim S.H. Shear wave elastography for detection of prostate cancer: a preliminary study // Korean J. Radiol. 2014. V. 15. No. 3. P. 346-355.

8. Correas J.M., Tissier A.M., Khairoune A., Vassiliu V., Mejean A., Helenon O., Memo R., Barr R.G. Prostate cancer: diagnostic performance of real-time shear-wave elastography // Radiology. 2015. V. 275. No. 1. P. 280-289.

9. Boehm K., Salomon G., Beyer B., Schiffmann J., Simonis K., Graefen M., Budaeus L. Shear wave elastography for localization of prostate cancer lesions and assessment of elasticity thresholds: implications for targeted biopsies and active surveillance protocols // J. Urol. 2015. V. 193. No. 3. P. 794-800.

10. Шевченко В.Е., Оленич А.В., Арноцкий Н.Е. Протеомика в открытии маркеров рака предстательной железы // Успехи молекулярной онкологии. 2015. Т. 2. № 2. С. 17-28.

11. Митьков В.В., Васильева А.К., Митькова М.Д. Ультразвуковая эластография сдвиговой волны у больных с подозрением на рак предстательной железы // Ультразвуковая и функциональная диагностика. 2012. № 5. С. 18-29.