Ferrari F S, Scorzelli A, Megliola A, Drudi F M, Trovarelli S, Ponchietti R
Department of Radiological Sciences, University of Siena, Siena, Italy.
J Ultrasound. 2009 Mar;12(1):22-31. doi: 10.1016/j.jus.2009.01.001. Epub 2009 Feb 28.
To assess the diagnostic gain of transrectal real-time elastography (RTE) compared to transrectal B-mode ultrasonography (US) in the detection of tumors in patients suspected of having prostate cancer.
Eighty-four patients suspected of having prostate cancer on the basis of clinical and biochemical evaluation underwent transrectal US, RTE and transperineal prostate biopsy.
Biopsy was considered the gold standard. Analysis related to the total number of patients showed a B-mode US sensitivity of 56%, specificity 80%, positive predictive value (PPV) 70% and negative predictive value (NPV) 67%. Analysis related to the total number of biopsy cores showed sensitivity 33%, specificity 92%, PPV 69% and NPV 73%. In the patient-related analysis, RTE sensitivity was 51%, specificity 75%, PPV 64% and NPV 64%, while the core-related analysis showed sensitivity 36%, specificity 93%, PPV 72% and NPV 74%. Comparison of B-mode US and RTE diagnostic accuracy in the detection of tumors located in the peripheral zone of the prostate gland showed a significant difference. Analysis related to the total number of biopsy cores harvested in the peripheral zone of the prostate gland showed a B-mode US sensitivity of 48%, specificity 81%, PPV 75% and NPV 58%, whereas RTE achieved the following values: sensitivity 66%, specificity 78%, PPV 77%, and NPV 67%.
RTE is a valid addition to B-mode US, and RTE reached a higher accuracy than B-mode US in the evaluation of the peripheral zone of the prostate gland and in the selection of appropriate biopsy sites.
评估经直肠实时弹性成像（RTE）与经直肠B型超声（US）相比，在疑似前列腺癌患者肿瘤检测中的诊断增益。
84例基于临床和生化评估疑似前列腺癌的患者接受了经直肠超声、RTE和经会阴前列腺活检。
活检被视为金标准。对患者总数的分析显示，B型超声的敏感性为56%，特异性为80%，阳性预测值（PPV）为70%，阴性预测值（NPV）为67%。对活检芯总数的分析显示，敏感性为33%，特异性为92%，PPV为69%，NPV为73%。在患者相关分析中，RTE的敏感性为51%，特异性为75%，PPV为64%，NPV为64%，而芯相关分析显示敏感性为36%，特异性为93%，PPV为72%，NPV为74%。B型超声和RTE在检测前列腺外周区肿瘤的诊断准确性比较显示出显著差异。对在前列腺外周区采集的活检芯总数的分析显示，B型超声的敏感性为48%，特异性为81%，PPV为75%，NPV为58%，而RTE的结果如下：敏感性为66%，特异性为78%，PPV为77%，NPV为67%。
RTE是B型超声的有效补充，在评估前列腺外周区和选择合适的活检部位方面，RTE比B型超声具有更高的准确性。
