To evaluate pre-surgical quantitative transrectal shear wave elastography (SWE) in the detection and characterisation of radioresistant prostate cancer.
Twelve men with recurrent prostate cancer following external beam radiotherapy were included in a prospective protocol-driven study. All underwent MR imaging and quantitative shear wave elastographic assessment of recurrent disease prior to salvage laparoscopic radical prostatectomy procedures. Images were used to construct 3D mold printing and histopathological processing of surgical specimen. Statistical analyses including ROC were generated using software programmes.
There were 48 cancer foci identified on final histopathology using patient-specific mold-based approach in 12 patients. Mean number of lesion was 3.4 (range 2–4). Quantitative transrectal SWE showed a sensitivity and specificity 0.77 (95% CI 0.627–0.880) and 0.82 (95% CI 0.642–0.942), respectively. The diagnostic accuracy increased with increasing size of the lesions with overall AUC of 0.89.
In our series, quantitative transrectal SWE showed a good diagnostic accuracy in the detection and characterisation of recurrent prostate cancer following failed radiotherapy treatment. These findings may help in targeting biopsies or future focal treatment options.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, Sandler H (2006) Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 65:965–974**
Yock TI, Zietman AL, Shipley WU, Thakral HK, Coen JJ (2002) Long-term durability of PSA failure-free survival after radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 54:420–426
Kaffenberger SD, Keegan KA, Bansal NK, Morgan TM, Tang DH, Barocas DA, Penson DF, Davis R, Clark PE, Chang SS, Cookson MS, Herrell SD, Smith JA Jr (2013) Salvage robotic assisted laparoscopic radical prostatectomy: a single institution, 5-year experience. J Urol 189:507–513
Murphy DG, Pedersen J, Costello AJ (Sep 2008) Salvage robotic-assisted laparoscopic radical prostatectomy following failed primary high-intensity focussed ultrasound treatment for localised prostate cancer. J Robot Surg 2:201–203
Stephenson AJ, Shariat SF, Zelefsky MJ, Kattan MW, Butler EB, Teh BS, Klein EA, Kupelian PA, Roehrborn CG, Pistenmaa DA, Pacholke HD, Liauw SL, Katz MS, Leibel SA, Scardino PT, Slawin KM (2004) Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 291:1325–1332
Stephenson AJ, Slawin KM, Bianco FJ Jr, Scardino PT (2004) Perspectives on the natural history of recurrent prostate cancer after radical prostatectomy, based on the response to salvage radiotherapy. BJU Int 94:1210–1212
Chade DC, Shariat SF, Cronin AM, Savage CJ, Karnes RJ, Blute ML, Briganti A, Montorsi F, van der Poel HG, Van Poppel H, Joniau S, Godoy G, Hurtado-Coll A, Gleave ME, Dall’Oglio M, Srougi M, Scardino PT, Eastham JA (2011) Salvage radical prostatectomy for radiation-recurrent prostate cancer: a multi-institutional collaboration. Eur Urol 60:205–210
Heidenreich A, Porres-Knoblauch D, Epplen R, Piper C, Pfister DJ, Aachen EPC (2012) Radical salvage prostatectomy for locally recurrent prostate cancer after radiation therapy. J Clin Oncol 30:47
Heidenreich A, Richter S, Thuer D, Pfister D (2010) Prognostic parameters, complications, and oncologic and functional outcome of salvage radical prostatectomy for locally recurrent prostate cancer after 21st-century radiotherapy. Eur Urol 57:437–443
Salji M, Jones R, Paul J, Birrell F, Dixon-Hughes J, Hutchison C, Johansen TE, Greene D, Parr N, Leung HY, Cryotherapy in Prostate Cancer study (2014) Feasibility study of a randomised controlled trial to compare (deferred) androgen deprivation therapy and cryotherapy in men with localised radiation-recurrent prostate cancer. Br J Cancer 111:424–429
Bercoff J, Tanter M, Fink M (2004) Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 51:396–409
Bercoff J, Chaffai S, Tanter M, Sandrin L, Catheline S, Fink M, Gennisson JL, Meunier M (2003) In vivo breast tumor detection using transient elastography. Ultrasound Med Biol 29:1387–1396
Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J, Deffieux T, Gennisson JL, Fink M, Neuenschwander S (2010) Breast lesions: quantitative elastography with supersonic shear imaging–preliminary results. Radiology 256:297–303
Ahmad S, Cao R, Varghese T, Bidaut L, Nabi G (2013) Transrectal quantitative shear wave elastography in the detection and characterisation of prostate cancer. Surg Endosc 27:3280–3287
Boehm K, Salomon G, Beyer B, Schiffmann J, Simonis K, Graefen M, Budaeus L (2015) Shear wave elastography for localization of prostate cancer lesions and assessment of elasticity thresholds: implications for targeted biopsies and active surveillance protocols. J Urol 193:794–800
Woo S, Kim SY, Cho JY, Kim SH (2014) Shear wave elastography for detection of prostate cancer: a preliminary study. Korean J Radiol 15:346–355
Correas JM, Tissier AM, Khairoune A, Vassiliu V, Mejean A, Helenon O, Memo R, Barr RG (2015) Prostate cancer: diagnostic performance of real-time shear-wave elastography. Radiology 275:280–289
Sheikh N, Wei C, Szewczyk-Bieda M, Campbell A, Memon S, Lang S, Nabi G (2017) Combined T2 and diffusion-weighted MR imaging with template prostate biopsies in men suspected with prostate cancer but negative transrectal ultrasound-guided biopsies. World J Urol 35:213–220
Turkbey B, Mani H, Shah V, Rastinehad A, Bernardo M, Pohida T, Pang Y, Daar D, Benjamin C, McKinney Y, Trivedi H, Chua C, Bratslavsky G, Shih J, Linehan W, Merino M, Choyke P, Pinto PA (2011) Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. J Urol 186:1818–1824
Trivedi H, Turkbey B, Rastinehad AR, Benjamin CJ, Bernardo M, Pohida T, Shah V, Merino MJ, Wood BJ, Linehan WM, Venkatesan AM, Choyke PL, Pinto PA (2012) Use of patient-specific MRI-based prostate mold for validation of multiparametric MRI in localization of prostate cancer. Urology 79:233–239
Wei C, Lang S, Bidaut L, Doull R, Huang Z, Nabi G (2014) Computer aided image analysis and rapid prototyping molds using patient-specific MRI data for reliable comparison between imaging and histopathology of radical prostatectomy specimens. Br J Surg 101:67–67
Sheikh N, Wei C, Szewczyk-Bieda M, Campbell A, Memon S, Lang S, Nabi G (2016) Combined T2 and diffusion-weighted MR imaging with template prostate biopsies in men suspected with prostate cancer but negative transrectal ultrasound-guided biopsies. World J Urol 35:1–8
Abramowitz MC, Li T, Buyyounouski MK, Ross E, Uzzo RG, Pollack A, Horwitz EM (2008) The phoenix definition of biochemical failure predicts for overall survival in patients with prostate cancer. Cancer 112:55–60
Morgan PB, Hanlon AL, Horwitz EM, Buyyounouski MK, Uzzo RG, Pollack A (2007) Timing of biochemical failure and distant metastatic disease for low-, intermediate-, and high-risk prostate cancer after radiotherapy. Cancer 110:68–80
Ramalingam M, Lau W, Tan T, Fook S, Ngoi F, Cheng C (2008) Asians with localized prostate cancer treated with 3-dimensional conformal radiation therapy and adjuvant hormonal therapy: comparing Phoenix and American Society of Therapeutic Radiology and Oncology (ASTRO) definitions in an Asian population. Urology 71:506–510
Pokala N, Huynh DL, Henderson AA, Johans C (2016) Survival outcomes in men undergoing radical prostatectomy after primary radiation treatment for adenocarcinoma of the prostate. Clin Genitourin Cancer 14:218–225
Sarvazyan A, Hall TJ, Urban MW, Fatemi M, Aglyamov SR, Garra BS (2011) An overview of elastography: an emerging branch of medical imaging. Curr Med Imaging Rev 7:255–282
Garra BS (2007) Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q, 23:255–268
Cao R, Huang Z, Varghese T, Nabi G (2013) Tissue mimicking materials for the detection of prostate cancer using shear wave elastography: a validation study. Med Phys 40:022903
Barr RG (2012) Sonographic breast elastography: a primer. J Ultrasound Med 31:773–783
Correas JM, Tissier AM, Khairoune A, Khoury G, Eiss D, Helenon O (2013) Ultrasound elastography of the prostate: state of the art. Diagn Interv Imaging 94 551–560
Barr RG, Cosgrove D, Brock M, Cantisani V, Correas JM, Postema AW, Salomon G, Tsutsumi M, Xu HX, Dietrich CF (2017) WFUMB guidelines and recommendations on the clinical use of ultrasound elastography: part 5: prostate. Ultrasound Med Biol 43:27–48
Coakley FV, Teh HS, Qayyum A, Swanson MG, Lu Y, Roach M 3rd, Pickett B, Shinohara K, Vigneron DB, Kurhanewicz J (2004) Endorectal MR imaging and MR spectroscopic imaging for locally recurrent prostate cancer after external beam radiation therapy: preliminary experience. Radiology 233:441–448
Haider MA, Chung P, Sweet J, Toi A, Jhaveri K, Menard C, Warde P, Trachtenberg J, Lockwood G, Milosevic M (2008) Dynamic contrast-enhanced magnetic resonance imaging for localization of recurrent prostate cancer after external beam radiotherapy. Int J Radiat Oncol Biol Phys 70:425–430
Rouviere O, Valette O, Grivolat S, Colin-Pangaud C, Bouvier R, Chapelon JY, Gelet A, Lyonnet D (2004) Recurrent prostate cancer after external beam radiotherapy: value of contrast-enhanced dynamic MRI in localizing intraprostatic tumor–correlation with biopsy findings. Urology 63:922–927
Arumainayagam N, Kumaar S, Ahmed HU, Moore CM, Payne H, Freeman A, Allen C, Kirkham A, Emberton M (2010) Accuracy of multiparametric magnetic resonance imaging in detecting recurrent prostate cancer after radiotherapy. BJU Int 106:991–997
Brawer MK (2002) Radiation therapy failure in prostate cancer patients: risk factors and methods of detection. Rev Urol 4:S2–S11
Westphalen AC, Koff WJ, Coakley FV, Muglia VF, Neuhaus JM, Marcus RT, Kurhanewicz J, Smith-Bindman R (2011) Prostate cancer: prediction of biochemical failure after external-beam radiation therapy: kattan nomogram and endorectal MR imaging estimation of tumor volume. Radiology 261:477–486
Prostate Cancer, UK (PCUK); Grant Number: PG12-39.
Cheng Wei, Magda Szewczyk-Bieda, Paddy Nibblock, Emma Brown, Stephen Lang and Ghulam Nabi have no conflicts of interest or financial ties to disclose.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Wei, C., Szewczyk-Bieda, M., Nibblok, P. et al. Quantitative transrectal shear wave elastography undergoing salvage extraperitoneal laparoscopic radical prostatectomy following failed radiotherapy. Surg Endosc 32, 4552–4561 (2018). https://doi.org/10.1007/s00464-018-6207-z
- Prostate cancer