Ultrasound elastography in characterization of prostatic lesions: correlation with histopathological findings

Objective: Ultrasound elastography is increasingly used in the diagnosis of prostate cancer, however results are heterogeneous. We correlate in a large sample-size prospective study the accuracy of elastography, aiming to settle an accurate cut-off point for diagnosis and possibility of use as a screening tool. Methods: Prospective study that included 120 patients with mean age 59.5 ± 9.8 years, showing enlarged prostate by clinical examination with prostate-specific antigen >4 ng ml−1. The study was done using high frequency high resolution endorectal probe with real time tissue elastography. Grayscale ultrasound examination was done first with Doppler followed by elastography color-coded map and strain ratio measurement. Then, transrectal ultrasound-guided core biopsy was done from suspicious areas detected by elastography (totally or partly stiff by color-coded map or with relative increased strain ratio), besides standard six-quadrant core biopsy samples. Results: There was statistically significant difference (p < 0.001) regarding strain ratio in benign and malignant lesions. Strain ratio showed significant proportionate correlation with prostate-specific antigen level and Gleason pathological score, while no significant correlation noted with the age or the prostatic volume. A strain ratio with a cut-off value of 1.9 showed a sensitivity of 100%, specificity 93.8%, positive predictive value of 79.3%, negative predictive value 100 and 95% accuracy in differentiating between malignant and benign lesions. Conclusion: Strain ratio improves the detection of prostatic cancer with high sensitivity (100%) and high negative predictive value (100%). Advances in knowledge: Different prostatic lesions are mostly similar in grayscale ultrasound. Imaging plays an important role in differentiation of prostatic nodules. Ultrasound elastography may play an important role in distinguishing benign from malignant nodules.

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Estimate of negative predictive value of prostate specific antigen parameters and multiparametric magnetic resonance imaging for excluding prostate cancer at biopsy

Clinica Chimica Acta ◽

10.1016/j.cca.2019.03.330 ◽

2019 ◽

Vol 493 ◽

pp. S157

Author(s):

V. Pecoraro ◽

T. Trenti

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Negative Predictive Value ◽

Prostate Specific Antigen ◽

Predictive Value ◽

Specific Antigen ◽

Resonance Imaging ◽

Multiparametric Magnetic Resonance Imaging

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Endobronchial ultrasound elastography strain ratio for mediastinal lymph node diagnosis

Radiology and Oncology ◽

10.1515/raon-2015-0020 ◽

2015 ◽

Vol 49 (4) ◽

pp. 334-340 ◽

Cited By ~ 29

Author(s):

Ales Rozman ◽

Mateja Marc Malovrh ◽

Katja Adamic ◽

Tjasa Subic ◽

Viljem Kovac ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Nodes ◽

Predictive Value ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Endobronchial Ultrasound ◽

Lung Tumour ◽

Mediastinal Lymph Nodes ◽

Ratio Measurement ◽

Mediastinal Staging

AbstractBackground.Ultrasound elastography is an imaging procedure that can assess the biomechanical characteristics of different tissues. The aim of this study was to define the diagnostic value of the endobronchial ultrasound (EBUS) elastography strain ratio of mediastinal lymph nodes in patients with a suspicion of lung cancer. The diagnostic values of the strain ratios were compared with the EBUS brightness mode (B-mode) features of selected mediastinal lymph nodes and with their cytological diagnoses.Patients and methods.This prospective, single-centre study enrolled patients with an indication for biopsy and mediastinal staging after a non-invasive diagnostic workup of a lung tumour. EBUS with standard B-mode evaluation and elastography with strain ratio measurement were performed before endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Results.Thirty-three patients with 80 suspicious mediastinal lymph nodes were included. Malignant infiltration was confirmed in 34 (42.5%) lymph nodes. The area under the receiver operating characteristic curve for the strain ratio was 0.87 (p< 0.0001). At a strain ratio ≥ 8, the accuracy for malignancy prediction was 86.25% (sensitivity 88.24%, specificity 84.78%, positive predictive value [PPV] 81.08%, negative predictive value [NPV] 90.70%). The strain ratio is more accurate than conventional B-mode EBUS modalities for differentiating between malignant and benign lymph nodes.Conclusions.EBUS-guided elastography with strain ratio assessment can distinguish malignant from benign mediastinal lymph nodes with greater accuracy than conventional EBUS modalities. This new method may reduce the number of mediastinal EBUS-TBNAs and thus reduce the invasiveness and expense of mediastinal staging in patients with non-small lung cancer (NSCLC).

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Emerging biomarkers in the detection and prognosis of prostate cancer

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2014-0988 ◽

2015 ◽

Vol 53 (7) ◽

Cited By ~ 14

Author(s):

Xavier Filella ◽

Laura Foj

Keyword(s):

Prostate Cancer ◽

Early Detection ◽

Tumor Marker ◽

Negative Predictive Value ◽

Prostate Specific Antigen ◽

Predictive Value ◽

Specific Antigen ◽

Cancer Gene ◽

Prostate Cancer Gene 3 ◽

New Biomarkers

AbstractThe prostate-specific antigen (PSA) is currently the most used tumor marker in the early detection of the prostate cancer (PCa), despite its low specificity and low negative predictive value. New biomarkers, including urine prostate cancer gene 3 (

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Medically significant concentrations of prostate-specific antigen in serum assessed

Clinical Chemistry ◽

10.1093/clinchem/39.5.897 ◽

1993 ◽

Vol 39 (5) ◽

pp. 896-896

Author(s):

L H Bernstein ◽

R A Rudolph ◽

M M Pinto ◽

N Viner ◽

H Zuckerman

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Prostate Specific Antigen ◽

Predictive Value ◽

Specific Antigen ◽

Drug Assay ◽

Carcinoma Of The Prostate ◽

Urine Drug

Abstract Vol. 36 p. 517. In the article by L.H. Bernstein, R.A. Rudolph, M.M. Pinto, N. Viner, and H. Zuckerman entitled "Medically significant concentrations of prostate-specific antigen in serum assessed," 1990;36:515-8, the text describing Table 4 reports reversed values for sensitivity and positive predictive value and likewise for specificity and negative predictive value. The text should read, "Table 4, a reorganized Table 3, defines the occurrence of binary class patterns with respect to carcinoma of the prostate by stage compared with nondisease. The table allows the estimation of 44.4% sensitivity, 97.1% specificity, a negative predictive value of 79%, and a positive predictive value of 87.8% for PSA >22.8 ng/mL." Vol. 38 p. 2557. In the latter to the editor by J.D. Mitchell, B.J. Perrigo, and V.A. Mason-Daniel entitled "Falsely negative urine drug assay results due to filtration," 1992;38:2556-7, the units in the first paragraph at the top of p. 2557 should have been micrograms per liter (µg/L), not pg/L.

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In vivo stiffness assessment of patellar and quadriceps tendons by strain ultrasound elastography

Bio-Medical Materials and Engineering ◽

10.3233/bme-206016 ◽

2021 ◽

pp. 1-10

Author(s):

Surangika Wadugodapitiya ◽

Makoto Sakamoto ◽

Sayaka Suzuki ◽

Yusuke Morise ◽

Koichi Kobayashi

Keyword(s):

Knee Flexion ◽

Quadriceps Tendon ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Return To Sports ◽

Target Tissue ◽

Relative Stiffness ◽

Extension Mechanism ◽

Significant Difference

BACKGROUND: The patellar and quadriceps tendons are responsible for the extension mechanism of the knee joint and frequently become inflamed during sports. Diagnosis and determination of when an athlete can return to sports following these injuries are usually performed by assessing morphological features and functional outcomes. Nevertheless, mechanical properties are not being assessed. OBJECTIVE: To describe the stiffness characteristics of these two tendons over the range of knee flexion and to test the feasibility of using strain ultrasound elastography (SE). METHODS: SE with an acoustic coupler as the reference was performed for nine healthy males. Relative stiffness measurements were obtained using the strain ratio (SR = target tissue strain/reference strain) by placing the knee in five different flexion angles. Lower SR indicates higher relative stiffness. RESULTS: This study showed reliable measurement with good intra- and inter-rater agreement for SR at 30°. SR of the quadriceps tendon decreases as knee flexion increases, indicating increased relative stiffness. In the patellar tendon, no significant difference was observed between 30° and 60°. Beyond 60°, relative stiffness increased constantly. CONCLUSIONS: SE is a reproducible and feasible tool to monitor relative stiffness of the patellar and quadriceps tendons in routine clinical settings.

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