Added value of shear-wave elastography in the prediction of extracapsular extension and seminal vesicle invasion before radical prostatectomy.

Yi-kang Sun; Yang YU; Guang XU; Jian WU; Yun-yun Liu; Shuai Wang; Lin Dong; Li-hua Xiang; Hui-xiong XU

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Added value of shear-wave elastography in the prediction of extracapsular extension and seminal vesicle invasion before radical prostatectomy.

Author: Yi-Kang SUN ¹ ; Yang YU ² ; Guang XU ¹ ; Jian WU ¹ ; Yun-Yun LIU ¹ ; Shuai WANG ¹ ; Lin DONG ¹ ; Li-Hua XIANG ¹ ; Hui-Xiong XU ³
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1. Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China.
2. Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China.
3. Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai 200032, China.
Publication Type:Journal Article
Keywords: extracapsular extension; prostate cancer; seminal vesicle invasion; shear-wave elastography; transrectal ultrasound
MeSH: Male; Humans; Prostate/pathology*; Seminal Vesicles/diagnostic imaging*; Elasticity Imaging Techniques; Retrospective Studies; Extranodal Extension/pathology*; Neoplasm Staging; Prostatectomy/methods*; Prostatic Neoplasms/pathology*; Magnetic Resonance Imaging/methods*
From: Asian Journal of Andrology 2023;25(2):259-264
CountryChina
Language:English
Abstract: The purpose of this study was to analyze the value of transrectal shear-wave elastography (SWE) in combination with multivariable tools for predicting adverse pathological features before radical prostatectomy (RP). Preoperative clinicopathological variables, multiparametric magnetic resonance imaging (mp-MRI) manifestations, and the maximum elastic value of the prostate (Emax) on SWE were retrospectively collected. The accuracy of SWE for predicting adverse pathological features was evaluated based on postoperative pathology, and parameters with statistical significance were selected. The diagnostic performance of various models, including preoperative clinicopathological variables (model 1), preoperative clinicopathological variables + mp-MRI (model 2), and preoperative clinicopathological variables + mp-MRI + SWE (model 3), was evaluated with area under the receiver operator characteristic curve (AUC) analysis. Emax was significantly higher in prostate cancer with extracapsular extension (ECE) or seminal vesicle invasion (SVI) with both P < 0.001. The optimal cutoff Emax values for ECE and SVI were 60.45 kPa and 81.55 kPa, respectively. Inclusion of mp-MRI and SWE improved discrimination by clinical models for ECE (model 2 vs model 1, P = 0.031; model 3 vs model 1, P = 0.002; model 3 vs model 2, P = 0.018) and SVI (model 2 vs model 1, P = 0.147; model 3 vs model 1, P = 0.037; model 3 vs model 2, P = 0.134). SWE is valuable for identifying patients at high risk of adverse pathology.