The Role of Virtual Touch Tissue Quantification Technique in Differentiating Between Benign Prostatic Hyperplasia and Prostatic Carcinoma

INTRODUCTION: Virtual Touch Tissue Quantification (VTTQ) is a promising new implementation of the acoustic radiation force pulsed ultrasound technique that has gained popularity in recent years. The present study compares the performance of the VTTQ technique in distinguishing between prostate cancer (PCa) and benign prostatic hyperplasia (BPH).
METHODS: VTTQ was performed on 91 prostate nodular lesions in 72 patients with BPH and suspected PCa prior to a prostate histopathologic examination, while 35 healthy volunteers were included in the study as controls. The mean shear wave velocity (SWV) values of the central and peripheral prostate zone were measured in the healthy volunteers, with the SWV at each nodular lesion quantified through the implementation of an acoustic radiation force impulse (ARFI). The performance of VTTQ in discriminating between PCa and BPH was compared, and the diagnostic value of VTTQ for PCa was evaluated in terms of sensitivity, specificity and cut-off value.
RESULTS: Histopathological examinations detected PCa in 21 of the 91 nodular lesions and BPH in 70. The SWV values (m/s) were significantly higher in prostate cancer than in the BPH and central-peripheral prostate zones (3.85±0.78, 2.29±1.03, 1.65 ±0.95, 1.14±0.56). The mean SWV values of the central-peripheral prostate zones were found to be significantly different from each other. We determined an SWV cut-off value of 3.09 m/s for differentiating between benign and malignant nodules, with a sensitivity and specificity of 90.5% and 80%, respectively.
DISCUSSION AND CONCLUSION: VTTQ can effectively determine the stiffness of prostate nodular lesions, with significantly higher performance discrimination between PCa and BPH.