Real-time elastography in the detection of prostate cancer in patients with raised PSA level

The study was done to evaluate the role of real-time elastosonography (ES) in the detection of prostate cancer (PCa) in 50 consecutive patients with raised PSA level and to determine whether ES can be of use to perform a targeted biopsy. Fifty consecutive patients with raised PSA levels underwent transrectal ultrasound (TRUS) and ES examination. ES images with adequate compression and a quality factor of more than 50% were analyzed for areas of increased glandular stiffness. The ES findings were correlated with the targeted and 10-core biopsy and sensitivity, specificity calculated on per patient and per core basis. ES showed a sensitivity and specificity of 91.7% and 86.8% on per patient basis, respectively, with a false positive rate of 13%. The calculated sensitivity and specificity on per core basis of ES targeted biopsy was 72.5% and 100% compared with 100% and 81% of 10-core systematic biopsy group. The study concludes that combining ES with TRUS significantly improves the sensitivity to detect carcinoma prostate in patients with raised PSA, however, ES is unable to differentiate PCa from chronic prostatitis. The use of ES for targeted biopsy also improves the specificity over a 10-core systematic biopsy.