To evaluate the pathological correlation and prognostic value of tissue stiffness measured by shear wave elastography (SWE) in bladder cancer

Introduction and Objective: To evaluate the pathological correlation of tissue stiffness measured by shear wave elastography (SWE) in bladder cancer. Materials and Methods: Patients who referred to our hospital due to microscopic or macroscopic hematüria and detected bladder tumor included in our study.Ten valid elastography measurements were performed with the abdominal convex probe of the Samsung Medison RS80A Prestige (Samsung Medison Co. Ltd., Seoul, Korea) ultrasonography device from the bladder tumor detected during the ultrasonography examination.Median values were used for statistical analysis. Tumor specimens were obtained by transurethral resection of bladder (TUR-B). Microvessel density (MVD) was determined by immunostaining of endothelial cells using Anti-CD34 antibody and hot-spot method. Correlation of tissue stiffness measured by SWE and microvessel density with histopathological stage and grade was identified using appropriate statistical analysis. Results: 43 cases of high-grade (HG) and 22 cases of low-grade (LG) ürothelial carcinoma were enrolled in the study. According to tumor stage, 11 cases of Ta LG, 11 cases T1 LG, 28 cases of T1 HG and 15 cases of T2 HG were reported. Tissue stiffness measured by SWE was significantly higher in the high grade urothelial carcinoma group(p=0.001).T1 HG and T2 HG grups had significantly higher mean elasticity than Ta LG group(p<0.001, p=0.04).Similar to tissue stiffness, high-grade group had higher microvessel density than the low-grade group(p=0.002).T1 HG and T2 HG grups had significantly higher MVD than Ta LG group(0.01, 0.004). Tissue stiffness of patients with pathological recurrence was significantly higher than the group without recurrence (p=0.007). Conclusion: Tissue stiffness of the bladder cancer correlates with the pathological grade. Stiffer tumoral tissue is associated with higher recurrence rate. Shear wave elastography can be an important guide with noninvasive, histopathological and prognostic predictive value in bladder cancer. Keywords:Bladder cancer, shear wave elastography, microvessel density