Objectives: The purpose of this study was to compare the value of real-time sonoelastography with T2-weighted endorectal magnetic resonance imaging (MRI) for prostate cancer detection.
Methods: Thirty-three patients with an elevated prostate-specific antigen level were investigated with real-time sonoelastography and T2-weighted endorectal MRI for prostate cancer diagnosis before systematic prostate biopsy. Real-time sonoelastography was performed to assess prostate tissue elasticity, and hard areas were considered suspicious for prostate cancer. Low-signal intensity nodules on T2-weighted endorectal MRI were considered suspicious for prostate cancer. Imaging findings were assigned to 6 areas of the peripheral zone (sextants), and their cancer detection rates were compared.
Results: Overall, prostate cancer was detected in 13 of 33 patients (39.4%). Both real-time sonoelastography and T2-weighted endorectal MRI detected 11 cancer-positive patients (84.6%). Real-time sonoelastography showed 27 suspicious lesions in 198 sextants, and 15 (55.6%) were cancer positive. T2-weighted endorectal MRI showed 31 suspicious lesions in 198 sextants, and 13 (40.6%) were cancer positive. These findings resulted in sensitivity rates and negative predictive values per patient of 84.6% and 86.7%, respectively, for sonoelastography and 84.6% and 83.3% for MRI. The per-sextant analysis showed sensitivity rates and negative predictive values of 57.7% and 93.6% for sonoelastography and 50.0% and 92.2% for MRI.
Conclusions: Real-time sonoelastography showed comparable results as T2-weighted endorectal MRI for prostate cancer detection.