The Diagnostic Value Of Multimodal Ultrasound In Prostate Cancer

Part 1: Diagnostic Value of Conventional Ultrasound and PSA in Prostate CancerObjectives: To investigate the diagnostic value of conventional ultrasound and PSA for prostate cancerMethods:A total of 129 patients with clinical suspicion of prostate cancer who underwent puncture biopsy or surgical resection from June 2020 to December 2022 were selected,divided into benign and malignant groups,and all patients underwent preoperative PSA and transrectal ultrasonography to analyze the conventional ultrasound features of the prostate and compare them with pathological findings.To summarize the conventional ultrasound features of prostate cancer and to evaluate the value of conventional ultrasound features in the combined diagnosis of prostate cancer.Results:In the clinical data,age,PSA,prostate volume,and PSA density were statistically different between the two groups.the positive predictive value,negative predictive value,sensitivity,specificity,and accuracy were 80.32%,76.47%,75.38%,81.25%,and 78.29%,respectively.The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of PSA density in the diagnosis of prostate cancer were 83.58%,89.83%,87.30%,82.81% and 82.17%,respectively.The conventional ultrasound features of prostate cancer are hypoechoic,irregular shape,unclear boundary,may be accompanied by microcalcifications,unclear demarcation of internal and external glands,incomplete and smooth envelope part,and asymmetric color Doppler blood flow signal.The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of the combined 2D conventional ultrasound features for the diagnosis of prostate cancer were 75.56%,65.12%,53.13%,86.15%,and 69.77%,respectively;the positive predictive value,negative predictive value,sensitivity,specificity and accuracy of color Doppler for the diagnosis of prostate cancer were 73.01%,72.73%,71.87%,73.85%,and 72.87%.Conclusions:Conventional ultrasound and PSA have some diagnostic value for prostate cancerPart 2: Diagnostic value of transrectal contrast-enhanced ultrasound in prostate cancerObjectives: To evaluate the value of contrast-enhanced ultrasound in the diagnosis of prostate cancer.Methods: A total of 129 cases of clinically suspected prostate cancer patients who received puncture biopsy or surgical resection in our hospital from June 2020 to December 2022 were selected.All of them underwent contrast-enhanced ultrasound examination before surgery to analyze the contrast-enhanced ultrasound characteristics of prostate,summarize the contrast-enhanced ultrasound characteristics of prostate,and evaluate the value of contrast-enhanced ultrasound characteristics combined with the diagnosis of prostate cancer.Results: The contrast-enhanced ultrasound features of prostate cancer were fast-forward enhancement,hyperperfusion,unequal enhancement,fast-backward enhancement and diffuse enhancement.The positive predictive value,negative predictive value,sensitivity,specificity and accuracy were 78.38%,89.09%,90.62%,75.38% and 82.95%,respectively.Conclusions: Contrast-enhanced ultrasound has a high diagnostic value for prostate cancer.Part 3: A comparative study of the diagnostic efficacy of Contrast enhance ultrasound combined with elastography and MRI for prostate cancerObjectives: To compare the diagnostic value of contrast-enhanced ultrasound、elastography、and the combination of both and MRI for prostate cancer.Methods: A total of 90 patients with clinical suspicion of prostate cancer who underwent puncture biopsy or surgical resection from May 2020 to December 2022 were selected.All patients underwent Contrast-enhanced ultrasound,elastography and magnetic resonance imaging(MRI).We compared the value of Contrast-enhanced ultrasound,elastography and the combination of both with MRI in the diagnosis of prostate cancer.Results: The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of Contrast-enhanced ultrasound for the diagnosis of prostate cancer were 74.07%,86.11%,88.89%,68.89%,and 78.89%,respectively.The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of elastography in diagnosing prostate cancer were 68.63%,74.36%,77.78%,64.44%,and 71.11%,respectively;the positive predictive value,negative predictive value,sensitivity,specificity and accuracy of the combination of the two in diagnosing prostate cancer were 65.15%,91.67%,95.56%,48.89%,72.22%,and The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of MRI alone were 63.76%,95.23%,97.78%,44.44%,and 71.11%,respectively.Ultrasonography had the highest accuracy and MRI had the highest sensitivity in diagnosing prostate cancer,but the difference in the area under the ROC curve between the three diagnoses of prostate cancer was not statistically significant(P < 0.05).Conclusions: Contrast-enhanced ultrasound has the highest accuracy in diagnosing prostate cancer,MRI has the highest sensitivity in diagnosing prostate cancer,and the combination of Contrast-enhanced ultrasound and elastography can improve the sensitivity.