Tsutsumi Masakazu, Miyagawa Tomoaki, Matsumura Takeshi, Kawazoe Natsui, Ishikawa Satoru, Shimokama Tatsuro, Shiina Tsuyoshi, Miyanaga Naoto, Akaza Hideyuki
Department of Urology, Hitachi General Hospital, Johnan-cho 2-1-1, Hitachi, Ibaraki, 317-0077, Japan.
Int J Clin Oncol. 2007 Aug;12(4):250-5. doi: 10.1007/s10147-007-0669-7. Epub 2007 Aug 20.
We evaluated the accuracy and feasibility of real-time elastography for detecting prostate cancer, using prostatectomy specimens.
This study was based on clinicopathological findings in 51 patients with prostate cancer who were referred for elastography at the time of prostate biopsy. We compared transverse pathology sections with elastographic moving images (EMIs) to determine the detection rate of cancer, the relationship between tumor location and the elastographic findings, and the relationship between the Gleason score and the elastographic findings.
In 15 patients (29%), all EMIs were in complete agreement with tumor location (category I), in 28 patients (55%), the EMIs agreed with tumor location, but showed some disagreement (category II), and in 8 patients (16%) there was disagreement of the elastographic findings with tumor location or the tumors were undetectable by elastography (category III). However, in category III, all tumors were detected as low-echoic by B-mode ultrasonography. We divided the prostate into three different regions (anterior, middle, and posterior), and found that 30/32 (94%) anterior tumors, 13/17 (76%) middle tumors, and 16/28 (57%) posterior tumors were detected by elastography. The proportions of cancers detected by elastography (categories I+II/total) was 100% in the patients with a Gleason score of 6, 85% in those with a score of 7 or 8, and 63% in those with a score of 9 or 10.
Real-time elastography in conjunction with B-mode ultrasonography significantly improves the detection of prostate cancer. One of the characteristic findings of elastography is its excellent detection of anterior tumors. The low detection rate of high-grade tumors in this analysis was likely due to the predominance of high-grade tumors in a peripheral location compared to the anterior location of the low-grade tumors.
我们使用前列腺切除标本评估了实时弹性成像检测前列腺癌的准确性和可行性。
本研究基于51例前列腺癌患者的临床病理结果，这些患者在前列腺活检时接受了弹性成像检查。我们将横向病理切片与弹性成像动态图像（EMIs）进行比较，以确定癌症的检出率、肿瘤位置与弹性成像结果之间的关系以及Gleason评分与弹性成像结果之间的关系。
在15例患者（29%）中，所有EMIs与肿瘤位置完全一致（I类）；在28例患者（55%）中，EMIs与肿瘤位置一致，但存在一些不一致（II类）；在8例患者（16%）中，弹性成像结果与肿瘤位置不一致或弹性成像无法检测到肿瘤（III类）。然而，在III类中，所有肿瘤通过B超均表现为低回声。我们将前列腺分为三个不同区域（前部、中部和后部），发现弹性成像检测到30/32（94%）的前部肿瘤、13/17（76%）的中部肿瘤和16/28（57%）的后部肿瘤。Gleason评分为6分的患者中，弹性成像检测到癌症的比例（I+II类/总数）为100%；评分为7或8分的患者中为85%；评分为9或10分的患者中为63%。
实时弹性成像结合B超显著提高了前列腺癌的检测率。弹性成像的一个特征性发现是其对前部肿瘤的出色检测能力。本分析中高级别肿瘤的低检测率可能是由于高级别肿瘤在外周位置占主导，而低级别肿瘤在前部位置较多。
