Olivier Rouvière1,2,3,4, Christelle Melodelima5,6, Au Hoang Dinh7, Flavie Bratan8,9,10,7, Gaele Pagnoux8, Thomas Sanzalone8,9,10, Sébastien Crouzet9,10,7,11, Marc Colombel9,10,11, Florence Mège-Lechevallier12, Rémi Souchon7. 1. Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, 69437, France. olivier.rouviere@netcourrier.com. 2. Université de Lyon, Lyon, 69003, France. olivier.rouviere@netcourrier.com. 3. Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France. olivier.rouviere@netcourrier.com. 4. Inserm, U1032, LabTau, Lyon, 69003, France. olivier.rouviere@netcourrier.com. 5. Université Joseph Fourier, Laboratoire d'Ecologie Alpine, BP 53, Grenoble, 38041, France. 6. CNRS, UMR 5553, BP 53, Grenoble, 38041, France. 7. Inserm, U1032, LabTau, Lyon, 69003, France. 8. Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, 69437, France. 9. Université de Lyon, Lyon, 69003, France. 10. Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France. 11. Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, 69437, France. 12. Hospices Civils de Lyon, Department of Pathology, Hôpital Edouard Herriot, Lyon, 69437, France.
Abstract
OBJECTIVES: To measure benign and malignant prostate tissue stiffness using shear-wave elastography (SWE). METHODS: Thirty consecutive patients underwent transrectal SWE in the axial and sagittal planes before prostatectomy. After reviewing prostatectomy specimens, two radiologists measured stiffness in regions corresponding to cancers, lateral and median benign peripheral zone (PZ) and benign transition zone (TZ). RESULTS: Cancers were stiffer than benign PZ and TZ. All tissue classes were stiffer on sagittal than on axial imaging, in TZ than in PZ, and in median PZ than in lateral PZ. At multivariate analysis, the nature of tissue (benign or malignant; P < 0.00001), the imaging plane (axial or sagittal; P < 0.00001) and the location within the prostate (TZ, median PZ or lateral PZ; P = 0.0065) significantly and independently influenced tissue stiffness. On axial images, the thresholds maximising the Youden index in TZ, lateral PZ and median PZ were respectively 62 kPa, 33 kPa and 49 kPa. On sagittal images, the thresholds were 76 kPa, 50 kPa and 72 kPa, respectively. CONCLUSIONS: SWE can distinguish prostate malignant and benign tissues. Tissue stiffness is influenced by the imaging plane and the location within the gland. KEY POINTS: • Prostate cancers were stiffer than the benign peripheral zone • All tissue classes were stiffer on sagittal than on axial imaging • All tissue classes were stiffer in the transition zone than in the peripheral zone • All tissue classes were stiffer in the median than in the lateral peripheral zone • Taking into account imaging plane and zonal anatomy can improve cancer detection.
OBJECTIVES: To measure benign and malignant prostate tissue stiffness using shear-wave elastography (SWE). METHODS: Thirty consecutive patients underwent transrectal SWE in the axial and sagittal planes before prostatectomy. After reviewing prostatectomy specimens, two radiologists measured stiffness in regions corresponding to cancers, lateral and median benign peripheral zone (PZ) and benign transition zone (TZ). RESULTS:Cancers were stiffer than benign PZ and TZ. All tissue classes were stiffer on sagittal than on axial imaging, in TZ than in PZ, and in median PZ than in lateral PZ. At multivariate analysis, the nature of tissue (benign or malignant; P < 0.00001), the imaging plane (axial or sagittal; P < 0.00001) and the location within the prostate (TZ, median PZ or lateral PZ; P = 0.0065) significantly and independently influenced tissue stiffness. On axial images, the thresholds maximising the Youden index in TZ, lateral PZ and median PZ were respectively 62 kPa, 33 kPa and 49 kPa. On sagittal images, the thresholds were 76 kPa, 50 kPa and 72 kPa, respectively. CONCLUSIONS: SWE can distinguish prostate malignant and benign tissues. Tissue stiffness is influenced by the imaging plane and the location within the gland. KEY POINTS: • Prostate cancers were stiffer than the benign peripheral zone • All tissue classes were stiffer on sagittal than on axial imaging • All tissue classes were stiffer in the transition zone than in the peripheral zone • All tissue classes were stiffer in the median than in the lateral peripheral zone • Taking into account imaging plane and zonal anatomy can improve cancer detection.
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