Source: DGNews  |  Posted 8 years ago

By W. A. Thomasson, PhD

CHICAGO, IL -- December 8, 2003 -- Real-time elastography, also known as "strain imaging," represents an effective method for identifying prostate cancers, according to a presentation held December 5th here at the Annual Meeting of the Radiological Society of North America.

This represents the first use of real-time elastography for the detection of prostate cancer.

Real-time elastography measures changes in the size and shape of sonographic features as the probe compresses them. Malignant lesions are typically stiff, and, therefore, show little change, while normal tissues and many benign lesions are relatively soft.

The reported study included 15 patients, all scheduled for radical prostatectomy consequent to biopsy-diagnosed prostate cancer, according to Andrea Klauser, MD, and his colleagues at the University of Innsbruck, Austria, and LP-IT Technologies in Bochum, Germany. At surgery, all patients had pT2 tumors 0.2 to 3.5 cm in size and with Gleason scores of 5 to 8. Two investigators read the elastographic images in consensus to identify size and location of tumor foci.

Pathology identified 32 cancer foci in 15 glands, with multiple foci being present in 13 glands. Elastography correctly identified 28 foci, with 4 false-positive and 4 false-negative results. All false-positive results, however, were encountered in the first 5 cases, suggesting a learning curve, while the average size of the missed cancer foci was 0.3 cm. At least 1 focus of cancer was identified in each patient.

As Dr. Klauser noted, not only was the number of patients in the study small, but also use of consensus reading meant that inter- and intraobserver variation could not be assessed. Furthermore, the study addressed only cancer detection against a largely normal background. "It would be interesting to see the findings in benign prostatic hyperplasia or other benign diseases," Dr. Klauser said.

The authors concluded nevertheless that, "Real-time elastography of the prostate is a sensitive new modality for the detection of prostate cancer."

[Study Title: Real-time Elastography for Prostate Cancer Detection: Preliminary Experience. Abstract T02-1395]