Quantitative transrectal shear wave elastosonography undergoing salvage extraperitoneal laparoscopic radical prostatectomy following failed radiotherapy
To evaluate pre- surgical quantitative transrectal shear wave elastosonongraphy (SWE) in the detection and characterisation of radioresistant prostate cancer
12 men with recurrent prostate cancer following external beam radiotherapy were included in a prospective protocol driven study. All underwent MRI imaging and quantitative shear wave elastosonographic assessment of recurrent disease prior to salvage laparoscopic radical prostatectomy procedures. Images were used to construct 3-D mold printing and histopathological processing of surgical specimen. Statistical analysis including ROC were generated using software programmes.
There were 48 cancer foci identified on final histopathology using patient specific mold based approach in 12 patients. Mean number of lesion was 3.4 (range 2 to 4). Quantitative transrectal SWE showed a sensitivity and specificity 0.77 (95% CI 0.627 - 0.880) and 0.82 (95% CI 0.642 - 0.942) respectively. The diagnostic accuracy increased with increasing size of the lesions with overall AUC of 0.89.
In our series quantitative transrectal SWE showed a good diagnosed accuracy in the detection and characterisation of recurrent prostate cancer following failed radiotherapy treatment. These findings may help in targeting biopsies or future focal treatment options.
Funding: PROSTATE CANCER,UK PC12-39