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European Radiology

, Volume 29, Issue 12, pp 6682–6689 | Cite as

Shear-wave elastography: role in clinically significant prostate cancer with false-negative magnetic resonance imaging

  • Li-Hua Xiang
  • Yan Fang
  • Jing Wan
  • Guang Xu
  • Ming-Hua Yao
  • Shi-Si Ding
  • Hui Liu
  • Rong WuEmail author
Ultrasound

Abstract

Objectives

To analyze the diagnostic value of adding SWE to MRI for the diagnosis of clinically significant prostate cancer with false-negative MRI results.

Methods

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.

Results

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.

Conclusions

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.

Key Points

• 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.

Keywords

Prostate cancer Biopsy Magnetic resonance imaging 

Abbreviations

95%CI

95% confidence intervals

ADC

Apparent diffusion coefficient

AHH

Atypical adenomatous hyperplasia

AP/CP

Acute/chronic prostatitis

ASAP

Atypical small acinar hyperplasia

AUC

Area under the ROC

BPH

Benign prostatic hyperplasia

DCE

Dynamic contrast enhancement

DWI

Diffusion-weighted imaging

fPSA

Free PSA

HGPIN

High-grade prostate intraepithelial neoplasia

LGPIN

Low-grade prostate intraepithelial neoplasia

mp-MRI

Multiparameter magnetic resonance imaging

NCI

National Cancer Institute

NPV

Negative predictive value

NSGP

Non-specific granulomatous prostatitis

PCa

Prostate cancer

PI-RADS

Prostate Imaging Reporting and Data System

PPV

Positive predictive value

PSA

Prostate-specific antigen

PSAD

PSA density

ROC

Receiver operator characteristic

ROI

Region of interest

sPCa

Clinically significant prostate cancer

SWE

Shear-wave elastography

T1WI

T1-Weighted imaging

T2WI

T2-Weighted imaging

TRUS-Bx

Transperineal prostate biopsy guided by transrectal ultrasound

US

Ultrasound

V

Volume of the prostate gland

Notes

Funding

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

Guarantor

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.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2019_6274_MOESM1_ESM.docx (9.4 mb)
ESM 1 (DOCX 9660 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Li-Hua Xiang
    • 1
    • 2
  • Yan Fang
    • 1
    • 2
  • Jing Wan
    • 1
    • 2
  • Guang Xu
    • 1
    • 2
  • Ming-Hua Yao
    • 1
    • 2
  • Shi-Si Ding
    • 1
    • 2
  • Hui Liu
    • 1
    • 2
  • Rong Wu
    • 1
    • 3
    Email author
  1. 1.Department of Medical Ultrasound, Shanghai Tenth People’s HospitalTongji University School of MedicineShanghaiChina
  2. 2.Ultrasound Research and Education InstituteTongji University School of MedicineShanghaiChina
  3. 3.Department of Ultrasound, Shanghai General HospitalShanghai Jiaotong University School of MedicineShanghaiChina

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