Department of Urology, Hitachi General Hospital, Hitachi, Ibaraki 317-0077, Japan.
AJR Am J Roentgenol. 2010 Jun;194(6):W471-6. doi: 10.2214/AJR.09.3301.
The use of elastography is limited for prostate cancer detection because of the difficulty in obtaining stable and reproducible images. To overcome these limitations, we developed a new technique called real-time balloon inflation elastography (RBIE); with RBIE, balloon inflation and deflation are used in place of manual compression. We present the accuracy and feasibility of the RBIE technique for detecting prostate cancer.
The results of a pathologic analysis of 55 prostatectomy specimens were compared with elastographic moving images obtained at the time of biopsy of the prostate.
The RBIE technique generated stable and repeatable elastographic moving images. The percentage of images affected by artifact due to slippage in the compression plane was reduced to 1% using the RBIE method compared with 32% using the manual compression method. With regard to tumor location, elastographic moving images obtained using the RBIE technique were in complete agreement with clinicopathologic evaluation of tumor location in eight cases (15%), showed partial agreement in 43 cases (78%), and disagreed in four cases (7%). In three different regions of the prostate, 84% of anterior tumors, 85% of middle tumors, and 60% of posterior tumors were detected. The tumor detection rates by Gleason score were 60% in tumors with a Gleason score of 5 or 6, 73% in tumors with a Gleason score of 7, 72% in tumors with a Gleason score of 8, and 74% in tumors with a Gleason score of 9 or 10.
The RBIE method improved the quality of elastographic moving images compared with the manual compression method. High-grade tumors and tumors of impalpable regions of the prostate were more frequently detected using RBIE. We conclude that RBIE is a promising method with which to detect prostate cancer.
由于难以获得稳定和可重复的图像，弹性成像在前列腺癌检测中的应用受到限制。为了克服这些限制，我们开发了一种称为实时球囊膨胀弹性成像（RBIE）的新技术；使用 RBIE，球囊充气和放气代替手动压缩。我们介绍了 RBIE 技术检测前列腺癌的准确性和可行性。
将 55 例前列腺切除术标本的病理分析结果与前列腺活检时获得的弹性成像动态图像进行比较。
RBIE 技术生成稳定且可重复的弹性成像动态图像。与手动压缩方法相比，使用 RBIE 方法可将因压缩平面滑动导致的伪影图像百分比降低至 1%，而手动压缩方法为 32%。关于肿瘤位置，使用 RBIE 技术获得的弹性成像动态图像与肿瘤位置的临床病理评估完全一致的有 8 例（15%），部分一致的有 43 例（78%），不一致的有 4 例（7%）。在前列腺的三个不同区域，84%的前位肿瘤、85%的中位肿瘤和 60%的后位肿瘤被检测到。Gleason 评分 5 或 6 的肿瘤检出率为 60%，Gleason 评分 7 的肿瘤检出率为 73%，Gleason 评分 8 的肿瘤检出率为 72%，Gleason 评分 9 或 10 的肿瘤检出率为 74%。
与手动压缩方法相比，RBIE 方法提高了弹性成像动态图像的质量。使用 RBIE 可以更频繁地检测到高级别肿瘤和前列腺触诊不可触及区域的肿瘤。我们得出结论，RBIE 是一种很有前途的前列腺癌检测方法。
