SWE of the Prostate and PI-RADS: Stiffness of the Peripheral Zone — What is Known and What is Missing in the Sources
What the Available Fragments Contain
The provided fragments do not present direct numerical stiffness thresholds for shear-wave elastography (SWE) of the prostate for differentiating cancer of the peripheral zone. There is also no information on the formalized integration of SWE into the PI-RADS system. Therefore, specific values of kPa/(m/s) and cut-off — [to be clarified] from the primary sources.
References on Prostate SWE in the Fragments
In the ACR-SRU parameter (ACR/SRU, 2024), the bibliography mentions works related to prostate SWE:
| Source (as named in the fragments) | Topic |
|---|---|
| Correas JM, Tissier AM, Khairoune A, et al. Prostate cancer: diagnostic performance of real-time shear-wave elastography. Radiology 2015;275:280-9 | Diagnostic performance of real-time SWE in prostate cancer |
| Wildeboer RR, Mannaerts CK, van Sloun RJG, et al. Automated multiparametric localization of prostate cancer based on B-mode, shear-wave elastography, and contrast-enhanced ultrasound radiomics. Eur Radiol 2020;30:806-15 | Multiparametric localization of cancer (B-mode + SWE + CEUS, radiomics) |
The numerical stiffness thresholds themselves are not cited in these fragments — they should be taken directly from the indicated publications [to be clarified].
General Methodological Principles (from Available Fragments)
From related elastography community materials, the following general methodological principles are applicable (not specific to the prostate):
The boundaries of the lesion are determined in B-mode, where spatial resolution and real anatomical contours are higher; the elastogram is a functional stiffness map in the same plane, superimposed on the B-mode. Compression elastography depends on pressure, depth, and preload, which generates artifacts (a hard halo beyond the node, "masking" the soft center).
For quantitative methods (using liver point SWE, ElastPQ as an example), the fragments indicate a requirement for measurement quality: the median of several measurements with IQR/Med ≤ 30%. Whether this value is applicable to the prostate is not indicated in the fragments [to be clarified].
Limitation
This material cannot provide valid SWE stiffness thresholds for prostate peripheral zone cancer and rules for their combination with PI-RADS, as such data are not present in the provided fragments. For clinical application, refer to the primary sources (Correas 2015; Wildeboer 2020) and current guidelines [to be clarified].
Frequently asked questions
Is there a specific SWE stiffness threshold for peripheral zone cancer in the fragments?
No. Numerical thresholds (kPa or m/s) are not provided in the fragments — [to be clarified] from primary sources Correas 2015 and Wildeboer 2020.
Is the integration of SWE with PI-RADS described in the fragments?
No. There is no data on the formalized combination of SWE and PI-RADS in the provided fragments [to be clarified].
Which studies on prostate SWE are mentioned?
In the ACR-SRU parameter (2024), Correas JM et al., Radiology 2015;275:280-9 and Wildeboer RR et al., Eur Radiol 2020;30:806-15 are mentioned.
What is the general principle of lesion marking in elastography?
First B-mode (boundaries, high resolution), then elastogram as a functional stiffness map in the same plane.
Is there a quality criterion for quantitative SWE measurements?
The fragments provide a criterion for liver point SWE: the median of several measurements with IQR/Med ≤ 30%. Applicability to the prostate is not indicated [to be clarified].