Trans-rectal quantitative Shear Wave Elastrography : application to prostate cancer – A feasibility study

Congress:

ECR 2011

Poster Number:

C-1748

Type:

Scientific Exhibit

Keywords:

Ultrasound, Elastography, Urinary Tract / Bladder, Oncology

Authors:

J.-M. Correas¹, A. KHAIROUNE², A.-M. Tissier³, V. Vassiliu³, D. EISS³, O. Hélénon²; ¹Paris Cedex 15/FR, ²Paris, Cedex 15/FR, ³Paris/FR

DOI:

10.1594/ecr2011/C-1748

DOI-Link:

https://dx.doi.org/10.1594/ecr2011/C-1748

Fig. 1: SWE study of a normal prostate. Note the homogeneous coding of the SWE signals...

Fig. 2: Patient presenting a soft benign nodule in mid peripheral prostate zone (left...

Fig. 3: Patient with no detected nodule on B-mode imaging. However, SWE revealed a...

Fig. 4: The hypoechoic nodule in the peripheral zone at mid prostate exhibited a strong...

Purpose

Prostate cancer is the 2nd leading cause of cancer death in men. It is also the most common diagnosed malignancy in men with near 190.000 new cases in the USA in 2008. Despite the larger use of biological tests (such as prostate specific antigen (PSA)) and imaging modalities (trans-rectal ultrasonography (TRUS) and Magnetic Resonance Imaging (MRI)), there is a slight increase in the annual death rate while the mortality remains stable. Due to the limited sensibility of TRUS (60 to 70%), a normal examination should...

Methods and Materials

21 patients presenting with increased PSA values (4-10 ng/mL) were prospectively enrolled after signing an informed consent form. The prostate was studied using trans-rectal ultrasound (TRUS) with spatial compounded B-mode, colour Doppler US (CDUS) and SWE on the Aixplorer system (Supersonic Imagine, Aix-en-Provence, France; transducer SE12-3). Elasticity measurements and ratios between nodules and adjacent parenchyma were calculated. Contrast-enhanced US (CEUS) was performed using low MI pulse subtraction after injection of 4.8-9.6 ml of SonoVue® (Bracco, Milan, Italy) using an Aplio XG system (Toshiba MS, Nasu,...

Results

In 3 patients, it was not possible to localize normal and abnormal patterns using SWE due to a technical problem during the export of the data. The analysis was performed from the remaining 18 patients (mean age 65 ± 6 years, min 54 – max 79). The PSA values were 6.9 ± 2.2 ng/mL. Eight patients exhibited significant prostate adenocarcinomas. Among the 26 nodules detected either at US or at pathology, 10 were adenocarcinomas with Gleason score above 6 and 16 were adenomatous hyperplasia or...

Conclusion

Trans rectal quantitative Shear Wave Elastography is a feasible technique for prostate cancer evaluation. It provides additional information about stiffness of nodules localized in the peripheral zone, complementary to that of CEUS. These preliminary results are encouraging but a larger multicentric evaluation remains necessary.

References

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