RESUMO
OBJECTIVE: â¢To evaluate whether transrectal real-time elastography (RTE) improves the detection of intraprostatic prostate cancer (PCa) lesions and extracapsular extension (ECE) compared with conventional grey-scale ultrasonography (GSU). PATIENTS AND METHODS: â¢In total, 229 patients with biopsy-proven PCa were prospectively screened for cancer-suspicious areas and ECE using GSU and RTE. â¢The largest tumour focus detected by RTE was defined as the index lesion. â¢The prostate gland was stratified into six sectors on GSU and RTE, which were compared with histopathological whole mount sections after radical prostatectomy. RESULTS: â¢Histopathologically, PCa was confirmed in 894 out of 1374 (61.8%) evaluated sectors and ECE was identified in 47 (21%) patients. â¢Of these 894 sectors, RTE correctly detected 594 (66.4%) and GSU 215 (24.0%) cancer suspicious lesions. â¢Sensitivity was 51% and specificity 72% using RTE compared to 18% and 90% for GSU. â¢RTE identified the largest side specific tumour focus in 68% of patients. â¢ECE was identified with a sensitivity of 38% and specificity of 96% using RTE compared to 15% and 97% using GSU. CONCLUSIONS: â¢Compared with GSU, RTE provides a statistically significant improvement in detection of PCa lesions and ECE. â¢RTE enhances GSU, although improvement is still needed to achieve a clinically meaningful sensitivity.