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The Scientific World Journal
Volume 2012, Article ID 193213, 6 pages
http://dx.doi.org/10.1100/2012/193213
Research Article

Potentials and Limitations of Real-Time Elastography for Prostate Cancer Detection: A Whole-Mount Step Section Analysis

1Department of Radiology, Medical University of Innsbruck, Anichstraß 35, 6020 Innsbruck, Austria
2Department of Pathology, Medical University of Innsbruck, Anichstraß 35, 6020 Innsbruck, Austria
3Department of Urology, Medical University of Innsbruck, Anichstraß 35, 6020 Innsbruck, Austria
4Department of Radiology, Hospital of the Sisters of Charity, 4020 Linz, Austria
5Thomas Jefferson Prostate Diagnostic Center, Thomas Jefferson University, Philadelphia, PA 19107, USA

Received 26 September 2012; Accepted 17 December 2012

Academic Editors: T. Esen and A. Tefekli

Copyright © 2012 Daniel Junker et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To evaluate prostate cancer (PCa) detection rates of real-time elastography (RTE) in dependence of tumor size, tumor volume, localization and histological type. Materials and Methods. Thirdy-nine patients with biopsy proven PCa underwent RTE before radical prostatectomy (RPE) to assess prostate tissue elasticity, and hard lesions were considered suspicious for PCa. After RPE, the prostates were prepared as whole-mount step sections and were compared with imaging findings for analyzing PCa detection rates. Results. RTE detected 6/62 cancer lesions with a maximum diameter of 0–5 mm (9.7%), 10/37 with a maximum diameter of 6–10 mm (27%), 24/34 with a maximum diameter of 11–20 20 mm (70.6%), 14/14 with a maximum diameter of >20 mm (100%) and 40/48 with a volume ≥0.2 cm3 (83.3%). Regarding cancer lesions with a volume ≥ 0.2 cm³ there was a significant difference in PCa detection rates between Gleason scores with predominant Gleason pattern 3 compared to those with predominant Gleason pattern 4 or 5 (75% versus 100%; ). Conclusions. RTE is able to detect PCa of significant tumor volume and of predominant Gleason pattern 4 or 5 with high confidence, but is of limited value in the detection of small cancer lesions.