European Journal of Molecular & Clinical Medicine

Abstract

Aim: The comparison of diagnostic accuracy for prostate cancer detection between
elastography plus MRI image based TRUS biopsy versus extended core biopsy.
Methods: This Comparative study was carried out in the Department of Radio Diagnosis,
Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal
Pradesh, India for the period of 6 months. 50 Patients with age group of 35 to 75 years, with
Serum PSA greater than 4.0 ng/dl were included in this study. All patient underwent TRUS
biopsy based on the MRI and elastography images, followed by TRUS guided extended core
biopsy (13 cores) done by radiologist randomly. The rate of prostate cancer detection was
compared between the two types of biopsies. Group A consisted of cores from MRI plus
Elastographyguided TRUS biopsy and Group B were cores from extended core biopsy.
Results: The mean age of patients was 63.71. The mean serum PSA for patients was 14.77
ng/dl (6.5 to 40.7). 20 cases presented with AUR and patients were catheterized. The mean
size of prostate in all 50 patients was 51.77 mg (29 to 84 mg). The mean size of prostate and
serum PSA of patients with carcinoma prostate were 14.9 mg and 18 ng/dl respectively.
Prostatic carcinoma detection with extended core biopsy was 42% (n=21). The incidence of
prostate cancer detection by MRI plus Elastography guided TRUS is 41 cases (82%). MRI
plus Elastography guided TRUS biopsy method is considered to be statistically significant as
the p value is 0.0369(since p < 0.05) as obtained by fishers exact test. In our study majority of
the patients had adenomatous hyperplasia (n=30,60%) as the HPE diagnosis, followed by
adenocarcinoma (n==20,40%). The sensitivity of mpMRI plus Elastography image based
TRUS biopsy method in detecting Prostate cancer was 84.5% and specificity was 82%. The
positive predictive value of this method was found to be 80%.
Conclusion: Although mpMRI and Elastography are individually useful for detection of
prostate malignancy, combining both the diagnostic tools for TRUS guided increases the rate
of cancer detection than that of extended core biopsy.