Ultrasound elastography: accurate, fast and painless

A new diagnostic tool is now available for patients with suspected prostate cancer. With real-time elastography, tumors in the prostate can be made more clearly visible. This not only enables improved early detection, but also more targeted tissue removal in the case of suspected prostate cancer.

Even if no malignant tumour is found during tissue removal, prostate cancer cannot be ruled out with certainty,"explains Dr. Pedram Derakhshani, urologist at the West German Prostate Center. In a biopsy, the urologist usually takes six to twelve samples, equivalent to only about one percent of the total prostate tissue. It is possible that smaller tumours may fall from the puncture grid,"explains Dr. Pedram Derakhshani, urologist at the West German Prostate Center.

Stretching capacity indicates tumour tissue

This is to be remedied by a new diagnostic method, so-called ultrasound-based elastography. Unlike conventional ultrasound procedures, which are used as standard in urological practice, elastography measures the elasticity of the prostate tissue. The following applies: The harder the tissue, the greater the probability that tumor tissue is present in this area of the prostate. 

With elastography, we are now able to detect tissue changes more reliably than with conventional ultrasound methods,"emphasizes Derakhshani. The examination is short and painless and takes place through the rectum, as with transrectal ultrasound. The doctor applies light pressure to the prostate with the ultrasound probe. Due to the different stretching properties between tumor and normal tissue, minimal time shifts of the echo signals occur. These are displayed on the monitor in color and in real time.

The innovative technology not only enables the more targeted collection of tissue samples for the diagnosis of prostate carcinoma, but in many cases also prevents a second biopsy,"said the Cologne urologist. Current studies 1/2 show that the hit rate of elastography is about twice as high as with conventional sonography.

The more differentiated the diagnosis, the more targeted the treatment of prostate cancer can be,"said the urologist from Cologne. Knowledge of the position and extent of the tumor is particularly useful in refined radiotherapeutic procedures such as brachytherapy (internal radiation). The more precisely we know the tumor, the more precisely we can irradiate it and the better neighboring organs such as the intestine, bladder and ureter can be protected, says Dr. Gregor Spira, radiotherapist at the West German Prostate Center.


  1. Pallwein Let al. (2008): Prostate cancer diagnosis: value of real-time elastography. Abdom imaging. 2008 Nov-Dec; 33 (6): 729-35. review.
  2. Pallwein, L et al. (2008) Ultrasound of prostate cancer: recent advances. Eur Radiol. 2008, Apr; 18 (4): 707-15. trument available.

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