الفهرس 
Anatomy of the Prostate GlandOnly 14 pages are availabe for public view
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Abstract
Background: Ultrasound Elastography is a new imaging technique based on estimation of the elastic properties of tissues and differentiating between benign and malignant prostatic lesions through the difference in tissue stiffness. Many studies have been performed to determine whether adding Elastography to conventional ultrasound is valuable or not. Results proved high specificity of elastography compared to Conventional ultrasound which may decrease the number of unnecessary biopsies. Elastography is performed in the same clinical setting with conventional B-mode ultrasonography. Images are produced prior to and post slight axial compression with the ultrasound probe, then image are displayed either by the lesion size comparison method or the color coding method.
Aim of the study: The aim of this study is to detect the impact of ultrasound elastography in diagnosis of early prostatic cancer, and to evaluate its capability in differentiating benign form malignant lesions, evaluation of sensitivity and specificity of sonoelastography, with histopthological diagnosis taken as the reference.
Patients and methods: The study was prospectively carried on 22 male patients with prostatic lesions, (between June 2020 to November 2022); the mean age was 63.5 years (age range: 52-76 years), a median of PSA of 30.6 ng/mL (range: 7-120), a median prostatic volume of 65 (range: 45-150 ml). This study was performed in the ultrasound unit/ radiology department of the Police Medical Complex at New-Cairo. Patients were referred from the outpatient clinic of the urology department.
Results: In the qualitative (color coded). evaluation of the sonoelastographic images, lesion classification was performed on the basis of a 5-point scoring method. Score 1: Homogeneous strain, the entire gland evenly shaded in green. Score 2: Symmetric heterogeneous strain, the gland shows a symmetrical mosaic pattern of green and blue. Score 3: Focal asymmetric lesion without strain, not related to hypoechoic lesion, the focal asymmetric lesion in blue. Score 4: Strain at the periphery of the hypoechoic lesion with sparing of the center of the lesion, the peripheral part of lesion in green and the central part in blue. Score 5: No strain in the entire hypoechoic lesion or in the surrounding area, the entire lesion in blue. Optimized settings of SWE include maximizing penetration and setting up an appropriate scale (70 to 90 kPa). Hypoechoic stiff lesions are suspicious for malignancy. The elasticity values (mean, standard deviation, min and max) are then calculated for each ROI. The ratio between the mean values of two ROIs placed in a suspicious region and in the adjacent normal peripheral zone can be calculated.
Conclusion: Elastography is an easy procedure with high diagnostic performance which can be easily integrated with the B-mode ultrasound examination in the same session and improves its specificity for detection of prostatic cancer. It has proven benefit in differentiating benign form malignant lesions and optimizing the results of prostate biopsies.