Elastography Targeted Prostate Biopsy in Patients under Active Surveillance

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Active surveillance is a strategy for managing prostate cancer (PCa).
• Elastography is an imaging technique used to assess tissue stiffness.
• The role of elastography in guiding biopsies for PCa patients on active surveillance requires evaluation.

Purpose of the Study:

• To evaluate the diagnostic performance of elastography-based prostate biopsy.
• To determine the reliability of elastography in predicting follow-up biopsy outcomes in PCa patients under active surveillance.

Main Methods:

• A cohort of PCa patients undergoing active surveillance were included.
• Elastography-guided targeted and systematic biopsies were performed.
• Diagnostic accuracy metrics (sensitivity, specificity, PPV, NPV, ACC) were calculated using bootstrapping.

Main Results:

• Of 50 men and 300 sextants, 27 men (54%) and 66 sextants (22%) had PCa on follow-up biopsy.
• Elastography showed a sensitivity of 19.7% and specificity of 86.8%.
• Positive predictive value was 29.6%, negative predictive value was 79.3%, and accuracy was 72.0%.

Conclusions:

• Elastography demonstrated limited reliability in predicting follow-up biopsy results for PCa patients on active surveillance.
• Findings do not support exclusive reliance on elastography-guided biopsies.
• Elastography results should not be used to delay or omit routine follow-up biopsies in active surveillance settings.