Value of Real-Time Elastography-Targeted Biopsy for Prostate Cancer Detection in Men: A Prospective Study of 194 Patients

Objectives: The main objective of this study is to define the impact of the elastography ultrasound in the guiding of prostatic biopsies in Algerian patients, by studying their efficiency in comparison to the results of published series. Methods: In this prospective study, 194 patients with clinical and biological suspicion of prostate cancer underwent color Doppler and elastography-guided biopsies. The mean age of our patients was 69.9 ± 8.7 years with the extremities between 43 and 87 years, the average of total prostate-specific antigen was 19.8 ± 1.8 ng/ml, and the digital rectal examination was pathological in 40.2% of patients. These patients underwent targeted biopsies at suspicious areas in color Doppler imaging and elastography, associated with 12-core randomized biopsies, and the histopathological results were correlated with imaging findings. Results: Ninety-eight patients (50.52%) were diagnosed as adenocarcinoma, among which 25 (27.4%) had a score >7. An elastographic anomaly was found among 88 patients (45.36%), 72 of them (81.8%) were cancerous, while 26 cancer cases (26.53%) had no elastographic rendition. The performances of elastography after result analysis came as follows: sensitivity: 73.2%, specificity (Sp): 82.83%, positive predictive value (PPV): 80.68%, negative predictive value: 75.93%. A strong relationship between the positive results of elastography and the high histological grade was found (odds ratio = 4). Conclusion: Due to its excellent Sp and PPV, elastography is an efficient method in detecting and characterizing the suspicious lesions to improve the efficiency.

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Artikel online veröffentlicht:
26. April 2021