Stiffness of prostate gland measured by transrectal real-time shear wave elastography for detection of prostate cancer: a feasibility study

Objective: This study aimed to evaluate the value of the Young's modulus obtained by transrectal real-time shear wave elastography (SWE) for detection of prostate cancer (PCa). Methods: 215 patients underwent SWE in six identical planes before biopsy guided with transrectal ultrasonography. The Young's modulus of the entire prostate gland was defined as the mean of the results in these planes. The measurements were compared with the pathological results, the prostate specific antigen (PSA), and the Gleason score (GS) after biopsy. Results: The Young's modulus of elasticity, including the maximum Young's modulus (Emax), the mean Young's modulus (Emean), and the minimum Young's modulus (Emin), were significantly higher in malignant lesions than those in benign lesions (all p < 0.05). The optimal cut-off values for PCa were 128.48 kPa, 62.27 kPa, and 20.03 kPa, respectively. The sensitivities were 77.88%, 81.42%, and 60.18%, respectively, and the specificities were 85.33%, 74.51 and 63.73 %, respectively. PSA positively correlated with Emax and Emean (r = 0.686 and 0.678, respectively), as did the GS (r = 0.410 and 0.382, respectively). Conclusion: The Young's modulus of entire prostate gland can be used to differentiate benign from malignant prostatic lesions. There were higher Young's modulus of elasticity and higher risk of malignant lesions. Meanwhile, higher Young's modulus correlated with higher PSA and GS. Advances In knowledge: This study indicates SWE can detect PCa by quantified the stiffness of entire prostate gland whether the lesions have been visible or not on gray-scale and Doppler ultrasound.