XXXX : Diagnostic Performance of Real-time Shear-Wave Elastography.

@entity1 @entity263 @entity2286 @entity420 @entity1486
UNASSIGNED: Purpose To prospectively evaluate the performance of real-time ultrasonographic (US) shear-wave elastography (SWE) in the diagnosis of @entity263 in @entity1 with high and/or increasing @entity1486 levels and/or abnormal digital rectal examination results. Materials and Methods After signing an informed consent form, @entity1 referred for transrectal prostate biopsy were enrolled in this prospective HIPAA-compliant two-center study, which was conducted with institutional review board approval. Transrectal US SWE of the prostate was performed after a conventional transrectal US examination and immediately before US-guided 12-core sextant biopsy. For each sextant, the maximum SWE value was measured and matched to the pathologic results of that sextant biopsy. The diagnostic performance of SWE was assessed at both @entity1 and sextant levels. The elasticity value maximizing the Youden index was used to derive sensitivity, specificity, positive predictive value ( @entity2286 ), and negative predictive value (NPV). Results The elasticity values were matched to pathologic results for a total of 1040 peripheral zone sextants in 184 @entity1 . One hundred twenty-nine positive biopsy findings (size, >= 3 mm; Gleason score, >= 6) were identified in 68 @entity1 . The sextant-level sensitivity, specificity, @entity2286 , NPV, and area under the receiver operating characteristic curve for SWE with a cutoff of 35 kPa for differentiating benign from malignant lesions were 96% (95% confidence interval [CI]: 95%, 97%), 85% (95% CI: 83%, 87%), 48% (95% CI: 46%, 50%), 99% (95% CI: 98%, 100%), and 95% (95% CI: 93%, 97%), respectively. Conclusion Use of a 35-kPa threshold at SWE may provide additional information for the detection and biopsy guidance of @entity263 , enabling a substantial reduction in the number of biopsies while ensuring that few peripheral zone @entity420 are missed.
