Application Value Of Transrectal Real-time Tissue Elastography Combined With PIRADS V2 In Diagnosis Of Prostate Cancer

Objective:To investigate the application value of transrectal real-time tissue elastography(TRTE)combined with multi-parameter magnetic resonance imaging(Mp-MRI)which based on the second edition of prostate imaging reporting and data system version 2.0(PIRADS V2)in diagnosis of prostate cancer(PCa).Materials and Methods:To analyze the diagnostic results of TRTE and Mp-MRI in sixty-eight patients with suspected PCa confirmed by pathology retrospectively.TRTE elastic score method and the strain rate ratio method(SR)were used to diagnose prostate cancer,and PIRADS V2 was used to diagnose prostate cancer by Mp-MRI.Combined with pathological results,to calculate the diagnostic rates of TRTE elastic score,strain rate ratio and PIRADS V2 for PCa and compare of the diagnostic efficiency between them.To Investigate the value of TRTE and PIRADS V2 used alone and in combination.To explore the correlation between the diagnostic results of TRTE and PIRADS V2 and pathological Gleason score and their clinical significance.Results:1.TRTE elastic score method diagnosis of prostate cancer showed the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 75.0%,77.8%,76.5%,75.0%and 77.8%respectively.2.Under ROC curve,the maximum Yoden index of of TRTE strain rate ratio method for PCa diagnosis is 0.600,and the corresponding optimal diagnostic threshold SR is 6.00.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TRTE strain rate ratio method for PCa diagnosis were 78.1%,80.5%,79.4%,78.1%and 80.6%,respectively.3.The area under ROC curve of TRTE strain rate ratio method is 0.799,the area under ROC curve of elastic score method is 0.764,and the diagnostic accuracy of strain rate ratio method is 78.1%,slightly higher than that of Ultrasonic Elastic score method 76.5%.The Z test shows that Z=0.390,P=0.6969.There is no significant difference between the two methods(P>0.05).4.The diagnostic results of PIRADS V2 for PCa by two MRI diagnosticians were consistent,Kappa=0.656.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PIRADS V2 in the diagnosis of PCa were 78.1%,83.3%,80.9%,80.6%and 83.3%,respectively.5.There was no significant difference between TRTE elasticity score method,TRTE strain rate ratio method and PIRADS V2 in the diagnosis of PCa(P>0.05);the efficiency of TRTE(elasticity score method combined with strain rate ratio method)combined with PIRADS V2 in the diagnosis of PCa was significantly higher than that of the two alone(P<0.05).6.TRTE elasticity score,PIRADS V2 detection rate of PCa and pathological Gleason score of PCa were correlated,Spearman grade correlation analysis showed a positive correlation,respectively:(rs=0.676,P=0.0000),(rs=0.673,P=0.0000),the difference was statistically significant.Conclusion:1.TRTE elastic score method and strain rate ratio method have important value in PCa diagnosis.TRTE strain rate ratio method provides quantitative indicators for the diagnosis of PCa,which is relatively objective and reliable,and is a useful supplement to the elastic scoring method.The best diagnostic threshold SR in this study was 6.00.2.PIRADS V2 has high consistency among different physicians of PCa and is of great value in the diagnosis of PCa.3.TRTE(elasticity score method combined with strain rate ratio method)combined with PIRADS V2 can significantly improve the diagnostic efiiciency of PCa and provide more reference for PCa diagnosis.4.There was a significant correlation between the detection rate of PCa by TRTE elasticity score and PIRADS V2 and pathological Gleason score of PCa.TRTE elasticity score and PIRADS V2 score can indirectly guide the prognosis to a certain extent,and become the reference indicators of PCa diagnosis and prognosis.