Elastography: Can It Improve Prostate Biopsy Results?

Prostate cancer is the leading malignancy in men and its accurate localization is of crucial importance for appropriate treatment selection. The evolution of prostate specific antigen (PSA) and transrectal ultrasound (TRUS) was the breakthrough for early detection and allowed new minimal invasive treatment modalities to evolve. Since the original application of TRUS by Holm, technological advancements substantially refined the quality of gray-scale and color (Doppler) imaging. Recently a new form of ultrasound extension called real time elastography has successfully been integrated into clinical practice. Elastography is based on palpation, one of the oldest principles of medicine and it gives information about the elasticity or stiffness of the tissues compared to the surrounding areas. Even though early impressions of this modality were promising, its efficacy has not been compared to the pathologic results obtained by a transperineal template-guided prostate biopsy, a form of extended biopsy that is considered today the most accurate method of constant, uniform sampling of the prostate gland.