[Impact of elastography in clinical diagnosis of prostate cancer. A comparison of cancer detection between B-mode sonography and elastography-guided 10-core biopsies].

BACKGROUND: To assess whether elastography guided prostate biopsies improve the cancer detection in men with suspected prostate cancer. PATIENTS AND METHODS: In this study, 351 prospectively randomized patients underwent prostate biopsies for the first time. The indication for biopsy was abnormal digital rectal examination (DRE) in 25% or suspicious prostate-specific antigen (PSA) elevation in 75%. In the elastography group (n=189) and the control group (n=162), we assessed PSA, DRE, and B-mode transrectal ultrasound (TRUS). Both groups underwent classic TRUS-guided 10-core biopsy. The elastography patients underwent additional elastographic examination prior to biopsy using a Voluson 730 ultrasound system (GE Medical). According to the ultrasound or elastographic findings for each biopsy location, the researcher tried to predict whether cancer was present. This prediction was correlated with histopathologic findings. The statistical power of this study was sufficient to detect a 15% difference in detection rate.
RESULTS: The study groups did not differ in PSA, clinical stages, or prostate volume (p<0.05). The overall cancer detection rate was 39% (137/351): 40.2% (76/189) in the elastography group and 37.7% (61/189) in the control group, respectively. The difference in detection rate in clinical stages T2 and T3 between the elastography and the control groups was not statistically significant (p<0.05). Within the T1c subgroup, elastography showed a slightly higher detection rate of 55.6% versus 50% without reaching statistical significance (p>0.05). Histopathologic findings were adequately predicted by elastography in only 44.5%.
CONCLUSIONS: Elastography did not improve the cancer detection rate in our collective.

RCT Entities:   Population Interventions Outcomes