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Elastographic Strain Index in the Evaluation of Focal Lesions Detected With Transrectal Sonography of the Prostate Gland
Author(s) -
Hwang Sung Il,
Lee Hak Jong,
Lee Sang Eun,
Hong Sung Kyu,
Byun Seok-Soo,
Choe Gheeyoung
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.01071
Subject(s) - medicine , elastography , receiver operating characteristic , prostate cancer , prostate , cutoff , biopsy , transrectal ultrasonography , radiology , ultrasound , area under the curve , strain (injury) , pathology , cancer , physics , quantum mechanics
Objectives The purpose of this study was to evaluate the value of elastography in evaluating focal lesions detected by transrectal sonography and to suggest a reference strain index. Methods Sixty‐nine patients with focal lesions on transrectal sonography were referred to our department for prostate biopsy. Focal lesions were classified as either highly or less suspicious lesions by our criteria. A strain index from elastography was calculated for the focal lesions. Systematic 12‐core randomized biopsies plus 2 targeted biopsies were performed. The mean strain indices for malignant and benign focal lesions were compared, and a cutoff strain index was attained to maximize the sensitivity and specificity for prostate cancer. Strain indices were correlated with Gleason scores. Results The mean strain index ± SD for malignant focal lesions (3.26 ± 1.77) was significantly higher than that for benign focal lesions (2.16 ± 1.52; P = .008). The sensitivity, specificity, and area under the receiver operating characteristic curve for diagnosing cancer were 66.7%, 71.1%, and 0.701, respectively, at a strain index cutoff value of greater than 2.4. The strain index showed a moderate linear correlation with the Gleason score ( r = 0.441; P = .013). Conclusions Any focal lesion on transrectal sonography with a strain index of greater than 2.4 is at risk for prostate cancer.