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Objective: To correlate quantitative tissue stiffness measurements obtained by transrectal ultrasound shear wave elastography (USWE) with PI-RADS scoring of multiparametric magnetic imaging resonance (mpMRI) using Gleason scores of radical prostatectomy as a reference standard. Patients and methods: 196 men with localised prostate cancer were prospectively recruited into the study and had quantitative prostate tissue stiffness measurements in kilopascals (kPa) using transrectal USWE prior to radical prostatectomy. PI-RADS scores of mpMRI were also obtained in all the men. Imaging and histopathology of radical prostatectomy specimen were oriented to each other using patient specific customised 3D moulds to guide histopathology grossing of radical prostatectomy specimens. All included patients had confirmed PCa on TRUS-guided biopsies, had both USWE and mpMRI imaging data, and underwent radical prostatectomy. Chi-square test with 95% confidence interval was used to assess the difference between Gleason score (GS) of radical prostatectomy and PI-RADS classification, as well as GS of radical prostatectomy and stiffness (in Kpa) using USWE. The correlation coefficient (r) was calculated in order to investigate relation between PI-RADS classification and tissue stiffness in kPa. Results: There was a statistically significant correlation between USWE-measured tissue stiffness and GS (χ2 (2, N = 196) = 23.577, p < 0.001). Also, there was a statistically significant correlation between Gleason score and PI-RADS score (χ2 (2, N = 196) = 12.838, p = 0.002). High PIRADS on MRI and high stiffness on USWE (> 100 kPa) detected more than 80% and 90% high risk prostate cancer disease. However, a weak correlation coefficient of 0.231 was observed between PI-RADS score and level of tissue stiffness measured in kPa. Conclusion: Quantitative USWE and mpMRI using PI-RADS classification provide a good degree of prediction for Gleason score of clinically significant prostate cancer (csPCa). Stiffer lesions on ultrasound showed a weak correlation with PI-RADS scoring system. USWE could be used to target suspected prostate cancer. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence suggesting that multiparametric magnetic resonance imaging (mpMRI) is a marker for prostate cancer (PCa) aggressiveness and could be used to plan treatment. Improving early detection of clinically significant PCa with pre-biopsy mpMRI would very likely have advantages including optimising the diagnosis and treatment of diseases and diminishing patient anxiety.Methods and Materials: This is a prospective multicentre study of pre-biopsy mpMRI diagnostic test accuracy with subgroup randomisation at a 1:1 ratio with respect to transrectal ultrasound (TRUS) and MRI/US fusion-guided biopsy or TRUS-only biopsy. It is designed as a single-gate study with a single set of inclusion criteria. The total duration of the recruitment phase was 48 months; however, this has now been extended to 66 months. A sample size of 600 participants is required.Discussion: The primary objective is to determine whether mpMRI can improve PCa detection and characterisation. The key secondary objective is to determine whether MRI/US fusion-guided biopsy can reduce the number of false-negative biopsies. Ethical approval was obtained from the East of Scotland Research Ethics Committee 1 (14/ES/1070) on 20 November 2014. The results of this study will be used for publication and presentation in national and international journals and at scientific conferences.Trial Registration: ClinicalTrials.gov, NCT02745496. Retrospectively registered on 20 April 2016. [ABSTRACT FROM AUTHOR]