DOI: https://doi.org/10.22263/2312-4156.2021.6.43
Derzhavets L.A.1, Krasny S.A.1, Letkovskaya T.A.2, Karman A.V.1, Maksimov D.M.1, Bakunovich V.A.1, Vanzindo E.I.2, Shimanets S.V.1
Early diagnosis of prostate cancer with the use of ultrasound shear wave elastography
1N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus
2Belarusian State Medical University, Minsk, Republic of Belarus
Vestnik VGMU. 2021;20(6):43-55.
Abstract.
The existing standard methods for the diagnosis of prostate cancer (PCa) have reached their limit in the detection of early forms of the disease. Fairly recently a new promising modality of transrectal ultrasound (US) has appeared – shear wave elastography (SWE), allowing to approach the solution of this problem.
Objectives. To increase the effectiveness of early diagnosis of PCa by evaluating the data of multiparametric magnetic resonance imaging (MRI), transrectal US with SWE (US-SWE) and systematic biopsy, supplemented by the target stage.
Material and methods. The material for the study was 186 patients with suspected PCa who underwent the following diagnostic measures: determination of the level of prostate specific antigen (PSA) isoforms with the calculation of calculated values, multiparametric MRI, transrectal US-SWE, biopsy (n=164) with separate labeling (t=126) and histological examination.
Results. Improved reporting system and terminology for data evaluation of transrectal US-SWE with final assessment categories of PCa possibility is presented. A new algorithm for early diagnosis of PCa using ultrasound elastography has been proposed. The incidence of PCa in the group of patients to whom the new diagnostic method [n=126] was applied made up 78/126 (61.9%), out of them GG (grade group of the International Society of Urological Pathology [ISUP]) ≥ 2 was in 39/126 (31.0%), which is better compared to the standard approach. Transrectal US-SWE allowed to identify additionally 13/78 (16.7%) PCa foci in the study group of 126 (10.3%) patients in whom PCa was not visualized on multiparametric MRI, of which GG ≥2 was in 6/13 (46.2%). PCa lesions revealed on transrectal US-SWE were localized mainly in the posterior zones (11/13 [84.6%]).
Conclusions. The developed method of early diagnosis of PCa by means of ultrasound SWE is effective and suitable for applying in clinical practice.
Key words: prostate specific antigen (PSA), prostate cancer (PCa), multiparametric magnetic resonance imaging (mpMRI), transrectal ultrasound (TrUS) with shear wave elastography (SWE) (TrUS-SWE), systematic and target stages of prostate biopsy.
The research work was conducted within the frames of the project «To elaborate and introduce into practice the methods of complex diagnostics of prostate and pancreas cancer using ultrasound elastography», the subprogram « Oncology» of the SSTP «New technologies of diagnosing, treatment and prevention», SR № 20192090.
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Information about authors:
Derzhavets L.A. – Doctor of Biological Sciences, head of the clinical diagnostic laboratory, N.N.Alexandrov National Cancer Centre of Belarus;
Krasny S.A. – Doctor of Medical Sciences, professor, corresponding member of the National Academy of Sciences of Belarus, deputy direct or for scientific work, N.N. Alexandrov National Cancer Centre of Belarus,
ORCID: https://orcid.org/0000-0003-3244-5664
Letkovskaya T.A. – Candidate of Medical Sciences, associate professor, head of the Chair of Pathologic Anatomy, Belarusian State Medical University,
ORCID:0000-0001-9086-2867;
Karman A.V. – Candidate of Medical Sciences, associate professor, leading research officer of the diagnostic laboratory with the radiology group, N.N. Alexandrov National Cancer Centre of Belarus,
ORCID: https://orcid.org/0000-0002-3045-3882
Maksimov D.M. – medical intern of the X-ray department, N.N. Alexandrov National Cancer Centre of Belarus,
ORCID: https://orcid.org/0000-0001-6308-2451
Bakunovich V.A. – medical intern of the X-ray department, N.N. Alexandrov National Cancer Centre of Belarus,
ORCID: https://orcid.org/0000-0002-5618-0544
Vanzindo E.I. – the fifth-year medical student, Belarusian State Medical University,
ORCID: https://orcid.org/0000-0002-2961-6576
Shimanets S.V. – research officer of the diagnostic laboratory with the radiology group, N.N. Alexandrov National Cancer Centre of Belarus,
ORCID: https://orcid.org/0000-0002-0898-4628
Correspondence address: Republic of Belarus, 223040, Minsk district, agrogorodok Lesnoy, N.N. Alexandrov National Cancer Centre of Belarus, the diagnostic laboratorywith the radiology group. E mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Sergey V. Shimanets.
