Objective: To investigate the value of strain patterns by transrectal real-time tissue elastography (TRTE) combined with transrectal ultrasonography (TRUS) in the differential diagnosis of the peripheral zone lesions of the prostate.
Methods: A total of 145 patients suspected of prostate cancer (PCa) underwent TRUS and TRTE examinations. Based on the features of the strain patterns, the lesions were classified into 5 grades, and the strain patterns were compared with the results of pathological diagnosis.
Results: High-quality images of TRTE were obtained in 124 (52 malignant and 72 benign) of the cases. According to the pathological results, malignancies accounted for 6.8% (3/44) in Grade I, 23.1% (3/13) in Grade II, 31.3% (5/16) in Grade III, 75.6% (31/41) in Grade IV and 100% (10/10) in Grade V, with statistically significant differences among the 5 grades (chi2 = 57.9, P < 0.01), and the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were 88.5%, 70.8%, 78.2%, 68.7% and 89.5% for TRTE, in comparison with 78.8%, 86.1%, 83.1%, 80.4% and 84.9% for the combination of TRTE and TRUS.
Conclusion: The combined use of strain patterns and TRUS is helpful to the differential diagnosis of prostate peripheral zone lesions.