Shear Wave Ultrasound Elastography of the Prostate Initial Results
Shear Wave Ultrasound Elastography of the Prostate Initial Results
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DOI：
10.1097/ruq.0b013e318249f594
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发表时间：
2012-03-01
影响因子：
1.3
通讯作者：
Schaub, Carl R.
中科院分区：
文献类型：
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作者：
Barr, Richard G.;Memo, Richard;Schaub, Carl R.
目的：本前瞻性研究旨在评价剪切波弹性成像（SWE）在前列腺癌（PC.Methods）诊断中的价值。对因前列腺特异性抗原水平升高或直肠指检结果异常而进行经直肠超声（TRUS）前列腺活检的患者进行标准TRUS和SWE检查。然后由对SWE结果不知情的第二名医生进行第二次TRUS检查和六分仪活检。结果：共53例患者（318个分型点）纳入本研究，所有病例均经病理证实，并计算敏感性、特异性、阴性预测值（NPV）和阳性预测值（PPV）。平均年龄为64.2岁（范围：53-79岁）。11例患者（20.7%）共检测到26个PC病灶。根据受试者工作特征曲线，将37 kPa作为良性和恶性之间的分界值。其敏感性为96.2%（25/26），特异性为96.2%（281/292），PPV为69.4%（25/36），NPV为99.6%（281/282）。11例假阳性样本中有6例（55%）继发于良性钙化。PC的杨氏模量范围为30 - 110 kPa（平均值[SD]，58.0 [20.7] kPa）。在病人的水平，如果使用40 kPa的截止，所有的PC将被检测到，和阳性活检率将是11（50%）的22相比，11（20.8%）的53没有SWE-一个140%的增加，在阳性活检率。结论：剪切波弹性成像具有较高的灵敏度，特异性，PPV，和NPV PC的检测。PPV高，前列腺特异性抗原水平升高或直肠指检结果异常且SWE阴性的患者可能不需要活检。这可以显著降低PC检测中的阴性活检率。
Purpose: This prospective study was to evaluate shear wave elastography (SWE) in the detection of prostate cancer (PC).Methods: Patients scheduled for a transrectal ultrasound (TRUS) biopsy of the prostate because of elevated prostate-specific antigen levels or abnormal digital rectal examination result underwent a standard TRUS and SWE. A second TRUS examination and sextant biopsy by a second physician blinded to SWE results was then performed. Pathologic result was reviewed, and sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated.Results: A total of 53 patients (318 sextants) participated in the study. Mean age was 64.2 years (range, 53-79 years). A total of 26 foci of PC were detected in 11 patients (20.7%). On the basis of the receiver operating characteristic curve, a value of 37 kPa was used as the cutoff between benign and malignant. This produced a sensitivity of 96.2% (25/26), a specificity of 96.2% (281/292), a PPV of 69.4% (25/36), and an NPV of 99.6% (281/282). Six (55%) of 11 false-positive samples were secondary to benign calcifications. The Young modulus of PC ranged from 30 to 110 kPa (mean [SD], 58.0 [20.7] kPa). At the patient level, if a cutoff of 40 kPa was used, all PCs would have been detected, and the positive biopsy rate would be 11 (50%) of 22 compared to 11 (20.8%) of 53 without SWE-a 140% increase in the positive biopsy rate.Conclusions: Shear wave elastography has a high sensitivity, specificity, PPV, and NPV for the detection of PC. With a high PPV, patients with elevated prostate-specific antigen levels or abnormal results in the digital rectal examination and negative SWE may not require biopsy. This could significantly reduce the negative biopsy rate in PC detection.