EARLY DIAGNOSIS OF PROSTATE CANCER WITH THE USE OF ULTRASOUND SHEAR WAVE ELASTOGRAPHY

Abstract

The existing standard methods for the diagnosis of prostate cancer (PCa) have reached their limit in the detection of early forms of the disease. Fairly recently a new promising modality of transrectal ultrasound (US) has appeared - shear wave elastography (SWE), allowing to approach the solution of this problem. Objectives. To increase the effectiveness of early diagnosis of PCa by evaluating the data of multiparametric magnetic resonance imaging (MRI), transrectal US with SWE (US-SWE) and systematic biopsy, supplemented by the target stage. Material and methods. The material for the study was 186 patients with suspected PCa who underwent the following diagnostic measures: determination of the level of prostate specific antigen (PSA) isoforms with the calculation of calculated values, multiparametric MRI, transrectal US-SWE, biopsy (n=164) with separate labeling (t=126) and histological examination. Results. Improved reporting system and terminology for data evaluation of transrectal US-SWE with final assessment categories of PCa possibility is presented. A new algorithm for early diagnosis of PCa using ultrasound elastography has been proposed. The incidence of PCa in the group of patients to whom the new diagnostic method [n=126] was applied made up 78/126 (61.9%), out of them GG (grade group of the International Society of Urological Pathology [ISUP]) ≥ 2 was in 39/126 (31.0%), which is better compared to the standard approach. Transrectal US-SWE allowed to identify additionally 13/78 (16.7%) PCa foci in the study group of 126 (10.3%) patients in whom PCa was not visualized on multiparametric MRI, of which GG ≥2 was in 6/13 (46.2%). PCa lesions revealed on transrectal US-SWE were localized mainly in the posterior zones (11/13 [84.6%]). Conclusions. The developed method of early diagnosis of PCa by means of ultrasound SWE is effective and suitable for applying in clinical practice.