Imaging of prostate cancer is becoming more important as new therapy options, such as focal ablation, gain in popularity. Precise knowledge of tumour location within the prostate and of the aggressiveness of this heterogeneous and multifocal tumour are key requirements for both established and new therapies and techniques. However, diagnosis still relies on biopsy results which might underestimate  tumour aggressiveness and/or bilateral disease.
Innovative imaging methods, such as MRI, elastography, histoscanning or contrast-enhanced ultrasonograpy, seem to increase the accuracy of tumour detection within the prostate, but for all these new methods there is one major drawback: a lack of data. Most study designs are unicentric with low patient numbers, and therefore do not show the usefulness of a particular technique.
Meta-analyses of current articles on new techniques are helpful as an overview of the potential benefit of these techniques. In the present paper, Danfeng Xu et al. showed the usefulness of sonoelastography; however, they also recognized that the studies included in their analysis had different designs and used different ultrasonography machines. A European multicentre study, with standardized technical equipment (in this case HI-RTE) and biopsy schemes, will be launched this year. These results should help to clarify the real benefit of elastography for improving the detection of prostate cancer.