Shear-wave elastography: role in clinically significant prostate cancer with false-negative magnetic resonance imaging
To analyze the diagnostic value of adding SWE to MRI for the diagnosis of clinically significant prostate cancer with false-negative MRI results.
This was a retrospective study of 367 patients who underwent MRI, SWE, and prostate biopsy between March 2016 and November 2018 at the Shanghai Tenth People’s Hospital. Serum prostate-specific antigen (PSA) and free PSA (fPSA) were measured preoperatively. Diagnostic value and accuracy was determined for MRI alone and MRI + SWE using the receiver operator characteristic curve (ROC) analysis.
MRI misdiagnosed 17.9% (21/117) clinically significant prostate cancers, including 15 lesions in the peripheral zone and 6 in the central zone. Both qualitative and quantitative SWE could help detect 66.7% (10/15) significant prostate cancers with false-negative MRI, but there was no association with the Gleason score (p > 0.05). When considering the sextant of the peripheral zone, a significant association was not seen with histopathology in qualitative SWE (p = 0.071) and quantitative SWE (p = 0.598). Among age, PSA, fPSA, volume of the prostate gland, fPSA/PSA, and PSAD, only PSAD (p = 0.019) was associated with SWE results in patients with negative MRI.
Adding SWE to MRI in patients with negative MRI for prostate examination could allow the correct diagnosis of additional patients and reduce the false-negative rate.
• MRI plays an important role in clinically significant prostate cancers diagnosis.
• SWE plays an important role in clinically significant prostate cancers with negative MRI.
• Adding SWE to MRI in patients with negative MRI for prostate examination could allow the correct diagnosis of additional patients and reduce the false-negative rate.
KeywordsProstate cancer Biopsy Magnetic resonance imaging
95% confidence intervals
Apparent diffusion coefficient
Atypical adenomatous hyperplasia
Atypical small acinar hyperplasia
Area under the ROC
Benign prostatic hyperplasia
Dynamic contrast enhancement
High-grade prostate intraepithelial neoplasia
Low-grade prostate intraepithelial neoplasia
Multiparameter magnetic resonance imaging
National Cancer Institute
Negative predictive value
Non-specific granulomatous prostatitis
Prostate Imaging Reporting and Data System
Positive predictive value
Receiver operator characteristic
Region of interest
Clinically significant prostate cancer
Transperineal prostate biopsy guided by transrectal ultrasound
Volume of the prostate gland
This study has received funding through Grant SHDC12016233 from the Shanghai Hospital Development Center, Grant 17411967400 from the Science and Technology Commission of Shanghai Municipality, and Grants 81471673 and 81671699 from the National Natural Science Foundation of China.
Compliance with ethical standards
The scientific guarantor of this publication is Rong Wu.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
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