Elastography for Prostate Stiffness

1. Introduction to Elastography 100%

Definition and Types (Strain vs Shear Wave Elastography)
Basic Physics of Tissue Stiffness Measurement
Advantages in Prostate Imaging
Comparison with Other Modalities (TRUS, MRI)

2. Prostate Anatomy and Zonal Importance 100%

Peripheral Zone (PZ) – High Cancer Incidence
Transition Zone (TZ) – Common for BPH
Central and Anterior Fibromuscular Zones
Importance of Zone-Based Stiffness Mapping

3. Elastography Techniques in the Prostate 100%

Strain Elastography: Manual Compression or Physiologic Pulsations
Shear Wave Elastography (SWE): Quantitative Stiffness Maps
Transrectal vs Transperineal Approaches
Color Maps, Stiffness Units (kPa or m/s), and ROIs
Equipment Settings and Optimization

4. Interpretation of Prostate Elastography 80%

Normal Peripheral Zone: Soft Elasticity (Low kPa)
Prostate Cancer: Focal Areas of Increased Stiffness
BPH: Diffuse Stiffening in TZ
Artifacts: Probe Pressure, Calcifications, Shadowing
Learning Curve and Pitfalls

5. Clinical Applications and Diagnostic Role

1. Prostate Cancer Detection

Suspicious Lesions: Stiff, Irregular, Non-homogeneous
PI-RADS Integration (MRI-US Fusion + SWE)
Increased Sensitivity and Specificity with Elastography

2. Biopsy Guidance

Targeted Biopsy of Hard Lesions
Avoiding Repeat Biopsies in Negative TRUS Cases
Guidance for Focal Therapy or Ablation Planning

3. BPH and Prostatitis

Distinguishing Focal Cancer from Diffuse TZ BPH
Chronic Prostatitis May Mimic Focal Stiffness
Elastography Patterns Over Time

6. Quantitative Metrics and Thresholds 30%

Normal Prostate Stiffness: ~20–40 kPa (Peripheral Zone)
Suspicious Lesions: > 60–80 kPa
Strain Ratios >2.5 Between Lesion and Background
Interpretation Depends on System Calibration

7. Research, Limitations, and Future Scope 0%

Operator Dependence in Strain Elastography
Need for Standardized Cutoffs
Use in Active Surveillance Patients
Integration with AI and Fusion-Guided Biopsy Platforms

8. Case Studies and Quiz Section 0%

Real-Life Cases with Imaging and Biopsy Correlation
SWE vs Strain Map Comparison
Image-Based MCQs on Stiffness Interpretation
Common Mistakes and Diagnostic Pearls