Junker Daniel, Schäfer Georg, Aigner Friedrich, Schullian Peter, Pallwein-Prettner Leo, Bektic Jasmin, Horninger Wolfgang, Halpern Ethan J, Frauscher Ferdinand
Department of Radiology, Medical University of Innsbruck, Anichstraß 35, 6020 Innsbruck, Austria.
ScientificWorldJournal. 2012;2012:193213. doi: 10.1100/2012/193213. Epub 2012 Dec 31.
To evaluate prostate cancer (PCa) detection rates of real-time elastography (RTE) in dependence of tumor size, tumor volume, localization and histological type.
Thirdy-nine patients with biopsy proven PCa underwent RTE before radical prostatectomy (RPE) to assess prostate tissue elasticity, and hard lesions were considered suspicious for PCa. After RPE, the prostates were prepared as whole-mount step sections and were compared with imaging findings for analyzing PCa detection rates.
RTE detected 6/62 cancer lesions with a maximum diameter of 0-5 mm (9.7%), 10/37 with a maximum diameter of 6-10 mm (27%), 24/34 with a maximum diameter of 11-20 20 mm (70.6%), 14/14 with a maximum diameter of >20 mm (100%) and 40/48 with a volume ≥0.2 cm(3) (83.3%). Regarding cancer lesions with a volume ≥ 0.2 cm³ there was a significant difference in PCa detection rates between Gleason scores with predominant Gleason pattern 3 compared to those with predominant Gleason pattern 4 or 5 (75% versus 100%; P = 0.028).
RTE is able to detect PCa of significant tumor volume and of predominant Gleason pattern 4 or 5 with high confidence, but is of limited value in the detection of small cancer lesions.
评估实时弹性成像（RTE）对前列腺癌（PCa）的检测率与肿瘤大小、肿瘤体积、位置及组织学类型之间的相关性。
39例经活检证实为PCa的患者在根治性前列腺切除术（RPE）前行RTE检查，以评估前列腺组织弹性，硬度较高的病变被视为PCa可疑病变。RPE术后，将前列腺制成连续的全层切片，并与影像学检查结果进行比较，以分析PCa的检测率。
RTE检测出最大直径为0 - 5mm的62个癌灶中的6个（9.7%），最大直径为6 - 10mm的37个癌灶中的10个（27%），最大直径为11 - 20mm的34个癌灶中的24个（70.6%），最大直径>20mm的14个癌灶中的14个（100%），以及体积≥0.2cm³的48个癌灶中的40个（83.3%）。对于体积≥0.2cm³的癌灶，Gleason主要模式为3的癌灶与Gleason主要模式为4或5的癌灶在PCa检测率上存在显著差异（75%对100%；P = 0.028）。
RTE能够高度准确地检测出具有显著肿瘤体积且Gleason主要模式为4或5的PCa，但在检测小癌灶方面价值有限。
