The utility of transrectal sonoelastography in preoperative prostate cancer assessment

To determine the diagnostic quality of transrectal sonoelastography (SE) in the prediction and localisation of prostate cancer, we prospectively examined patients who had undergone radical prostatectomy in our urology department.

From April 2010 to January 2011, 61 patients with biopsy-proven prostate cancer underwent preoperative transrectal gray-scale (b-mode) ultrasound and SE of the prostate. Cancer-suspicious areas were documented for b-mode and SE, dividing the prostate into six topographic sectors. Suspicious areas in both modalities were compared to tumour localisation in the prostatectomy specimen. Sensitivity, specificity, positive- and negative predictive values were calculated for both investigation techniques.

Prostate cancer was present in 232 of 366 pathological sectors (62 %). B-mode ultrasound showed 113 suspicious sectors, while SE indicated prostate cancer in 157 areas. The precise localisation of at least one pathologically confirmed cancerous lesion was possible in 42/61 (69 %) patients by b-mode ultrasound and 56/61 (92 %) patients by SE (P<0.005). The sensitivity for b-mode ultrasound was 33 % and specificity 74 %. For SE sensitivity was 53 %, while specificity was 74 %.

SE offers a more precise localisation of prostate carcinoma than conventional ultrasound. To investigate the possible advantages of SE in during prostate biopsy and its value in the prediction of extracapsular cancer further studies are required.