3D in vivo ARFI imaging: Prostate cancer sensitivity

Imaging tools that reliably visualize prostate cancer (PCa) are increasingly needed in the urological community. The objective of this research was to evaluate the ability of Acoustic Radiation Force Impulse (ARFI) imaging to localize PCa in 29 patients with biopsy-confirmed PCa who underwent radical prostatectomy and whole mount histopathology analysis. B-mode, ARFI imaging and whole mount histopathology volumes were acquired for each patient. Regions of suspicion (ROS) for PCa were reader-identified in ARFI images based on boundary delineation, contrast, texture and location, and compared to lesions identified in histopathology. ARFI imaging identified a total of 29 ROSs, 27 of which were correctly identified as cancer (PPV: 93%). ARFI imaging's overall sensitivity was 55%; however, there was significant variation in sensitivity depending on lesion type. We found that ARFI imaging was much more sensitive to posterior lesions (63%) than anterior lesions (12.5%). Posterior index lesions were identified with greater sensitivity (81%) than clinically-insignificant lesions (33%).