Application Of Dynamic 3D-CETRUS TUI In The Diagnosis Of Prostate Cancer And Targeted Prostate Biospy

Objective To assess the accuracy of detecting prostate cancer(PCa)by dynamic threedimensional contrast-enhanced transrectal tomographic ultrasound imaging(3D-CETRUS TUI)and dynamic 3D-CETRUS TUI and transrectal ultrasonography(TRUS)cognitive fusion-guided biopsy for prostate.Methods This study included 90 patients,who were elevated PSA(≥4 ng/ml)or abnormal rectal digital examination from November 2018 to March 2020.(1)All of the patients were examined by TRUS and 3D-CETRUS TUI,compared the sensitivity,specificity and accuracy of TRUS and dynamic 3D-CETRUS TUI in the diagnosis of benign and malignant prostate lesions.(2)All patients received transperineal systematic prostate biopsy(SPB).Subsequently,in case of positive dynamic 3D-CETRUS TUI,dynamic 3D-CETRUS TUI and TRUS cognitive fusion guided targeted prostate biopsy(TPB)were performed by a different doctor.We compared core-based cancer detection rates for each biopsy method.Result Among all 90 patients,36 cases were PCa,and 54 cases were diagnosed as benign lesions of prostate.Among them,33 cases were diagnosed as positive by traditional TRUS.The main manifestations were:(1)the boundary between the prostate peripheral zone and the transitional zone was blurred(12/33,36.4%);(2)local hypoechoic areas in the peripheral zone of the prostate(9/33,27.3%);(3)the prostate capsule was asymmetrically convex(2/33,6.0%).The sensitivity,specificity and accuracy of TRUS were 38.9%,64.8% and 54.4%,respectively.In dynamic 3D-CETRUS TUI,36 cases had positive results.Most of the contrast enhancement patterns(23/36,63.9%)showed "fast in,fast out,high enhancement";a small part(13/36,36.1%)showed no(or low)enhancement area and blurred boundary.The sensitivity,specificity and accuracy of dynamic 3D-CETRUS TUI in the diagnosis of benign and malignant prostatic lesions were 83.3%,88.9% and 86.7%,respectively.There were significant differences in sensitivity,specificity and accuracy between traditional TRUS and dynamic 3D-CETRUS TUI(P = 0.002,< 0.001 and < 0.001,Mc Nemar test).In 36 patients with positive findings of dynamic 3D-CETRUS TUI,a total of 432 SPB cores and 93 TPB cores were performed.Core-based cancer detection rates was higher in TPB(67.7%,63 of 93 cores)than in SPB(25.2%,109 of 432 cores)(χ2 =62.659,P<0.0001)Conclusion: In our study,the sensitivity,specificity and accuracy of dynamic 3D-CETRUS TUI for diagnosis of PCa were significantly higher.Dynamic 3DCETRUS TUI and TRUS cognitive fusion guided TPB has a higher core-based detection rate of prostate cancer compared with SPB.