Almalki Yassir Edrees, Mansour Mohamed Gamal El-Din, Ali Susan Adil, Basha Mohammad Abd Alkhalik, Abdelkawi Moustafa Mahmoud, Alduraibi Sharifa Khalid, Almushayti Ziyad A, Aldhilan Asim S, Aboualkheir Mervat, Amin Darine, Metkees Mohamed, Basha Ahmed M A, Ebaid Noha Yahia
Division of Radiology, Department of Internal Medicine, Medical College, Najran University, Najran, 61441, Kingdom of Saudi Arabia.
Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, 11566, Egypt.
Sci Rep. 2024 Feb 5;14(1):2917. doi: 10.1038/s41598-024-53440-2.
This study aimed to examine the validity and reproducibility of strain elastography (SE) for detecting prostate cancer (PCa) in patients with elevated prostate-specific antigen (PSA) levels. The study included 107 patients with elevated PSA levels. All eligible patients underwent transrectal ultrasound (TRUS) with real-time elastography (RTE) to detect suspicious lesions. Two readers independently evaluated the lesions and assigned a strain ratio and elastography score to each lesion. Histopathology was used as a reference standard to estimate the validity of RTE in predicting malignant lesions. An intraclass correlation (ICC) was performed to detect reliability of the strain ratios and elastography scores. TRUS-guided biopsy detected malignancies in 64 (59.8%) patients. TRUS with RTE revealed 122 lesions. The strain ratio index (SRI) cut-off values to diagnose malignancy were 4.05 and 4.35, with sensitivity, specificity, and accuracy of 94.7%, 91.3%, and 93.4%, respectively. An elastography score > 3 was the best cut-off value for detecting malignancy. According to readers, the sensitivity, specificity, and accuracy were 91.3-94.7%, 89.5-93.4%, and 91.3-90.9%, respectively. Excellent inter-reader agreement was recorded for SRI and elastography scores, with ICC of 0.937 and 0.800, respectively. SE proves to be an efficient tool for detecting PCa with high accuracy in patients with elevated PSA levels.
本研究旨在检验应变弹性成像（SE）在检测前列腺特异性抗原（PSA）水平升高患者的前列腺癌（PCa）方面的有效性和可重复性。该研究纳入了107例PSA水平升高的患者。所有符合条件的患者均接受经直肠超声（TRUS）及实时弹性成像（RTE）以检测可疑病变。两名阅片者独立评估病变，并为每个病变指定应变比和弹性成像评分。组织病理学用作参考标准以评估RTE预测恶性病变的有效性。进行组内相关系数（ICC）分析以检测应变比和弹性成像评分的可靠性。TRUS引导下活检在64例（59.8%）患者中检测到恶性肿瘤。TRUS联合RTE发现了122个病变。诊断恶性肿瘤的应变比指数（SRI）临界值分别为4.05和4.35，敏感性、特异性和准确性分别为94.7%、91.3%和93.4%。弹性成像评分>3是检测恶性肿瘤的最佳临界值。根据阅片者判断，敏感性、特异性和准确性分别为91.3% - 94.7%、89.5% - 93.4%和91.3% - 90.9%。SRI和弹性成像评分的阅片者间一致性良好，ICC分别为0.937和0.800。对于PSA水平升高的患者，SE被证明是一种高效、准确检测PCa的工具。
