Ma Qi, Yang Dong-Rong, Xue Bo-Xin, Wang Cheng, Chen Han-Bin, Dong Yun, Wang Cai-Shan, Shan Yu-Xi
Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China.
Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China.
Oncol Lett. 2017 Jul;14(1):210-216. doi: 10.3892/ol.2017.6126. Epub 2017 May 5.
The focus of the present study was to evaluate transrectal real-time tissue elastography (RTE)-targeted two-core biopsy coupled with peak strain index for the detection of prostate cancer (PCa) and to compare this method with 10-core systematic biopsy. A total of 141 patients were enrolled for evaluation. The diagnostic value of peak strain index was assessed using a receiver operating characteristic curve. The cancer detection rates of the two approaches and corresponding positive cores and Gleason score were compared. The cancer detection rate per core in the RTE-targeted biopsy (44%) was higher compared with that in systematic biopsy (30%). The peak strain index value of PCa was higher compared with that of the benign lesion. PCa was detected with the highest sensitivity (87.5%) and specificity (85.5%) using the threshold value of a peak strain index of ≥5.97 with an area under the curve value of 0.95. When the Gleason score was ≥7, RTE-targeted biopsy coupled with peak strain index detected 95.6% of PCa cases, but 84.4% were detected using systematic biopsy. Peak strain index as a quantitative parameter may improve the differentiation of PCa from benign lesions in the prostate peripheral zone. Transrectal RTE-targeted biopsy coupled with peak strain index may enhance the detection of clinically significant PCa, particularly when combined with systematic biopsy.
本研究的重点是评估经直肠实时组织弹性成像（RTE）靶向双芯活检联合峰值应变指数用于检测前列腺癌（PCa），并将该方法与十芯系统活检进行比较。共有141例患者纳入评估。使用受试者工作特征曲线评估峰值应变指数的诊断价值。比较两种方法的癌症检出率以及相应的阳性芯数和 Gleason 评分。RTE靶向活检的每芯癌症检出率（44%）高于系统活检（30%）。PCa的峰值应变指数值高于良性病变。使用峰值应变指数≥5.97的阈值，曲线下面积值为0.95时，检测PCa的灵敏度最高（87.5%），特异性为（85.5%）。当Gleason评分≥7时，RTE靶向活检联合峰值应变指数检测到95.6%的PCa病例，而系统活检检测到84.4%。峰值应变指数作为定量参数可改善前列腺外周区PCa与良性病变的鉴别。经直肠RTE靶向活检联合峰值应变指数可提高临床显著PCa的检测率，特别是与系统活检联合时。
