The combined value of mpUS and mpMRI-TRUS fusion for the diagnosis of clinically significant prostate cancer

Abstract

Objective To evaluate the combined efficacy of multiparametric ultrasonography (mpUS) and multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI-TRUS) fusion for detecting clinically significant prostate cancer (csPCa). Methods From November 2019 to September 2021, biopsy-naïve patients underwent mpMRI-TRUS fusion imaging combined with mpUS-guided targeted biopsies (TB) and systematic biopsies (SB). To further evaluate the additional diagnostic value of mpUS, the imaging features of 202 focus obtained from fusion imaging were assessed. The diagnostic accuracies of mpMRI-TRUS fusion imaging and the combination of mpMRI-TRUS fusion imaging with mpUS for csPCa were comparatively evaluated. Results A total of 202 prostate lesions (160 patients) were included in the final analysis, of which 105 were csPCa, 16 were ciPCa, and 81 were noncancerous. The median patient age was 69 (65–73) years and the median tPSA was 22.07 (11.22–62.80) ng/mL. For csPCa, the detection rate of TB was higher than that of SB (50.0% vs. 45.5%, p < 0.05). The imaging characteristics of mpUS in the PCa and non-PCa groups were significantly different (p < 0.001). When compared with mpMRI-TRUS fusion imaging, the positive predictive value, false positive rate, and area under the curve (AUC) of csPCa diagnosis by mpMRI-TRUS fusion imaging combined with mpUS increased by 11.30%, decreased by 19.58%, and increased from 0.719 to 0.770 (p < 0.05), respectively. Conclusion TB can improve the detection rate of csPCa and hence can be effectively used in the diagnosis and risk assessment of csPCa. The mpUS-enriched valuable diagnostic information for mpMRI-TRUS fusion imaging and their combination showed a higher diagnostic value for csPCa, which can guide subsequent clinical treatment.

Comparative Assessment of Different Ultrasound Technologies in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis

“…The inclusion criteria for the studies were either patients with a clinical suspicion of PC or patients with an elevated or increasing PSA. Moreover, 11 studies were performed with Micro-US [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], 2 studies with mpUS [ 30 , 42 ], 4 studies with grayscale [ 30 , 43 , 44 , 45 ], 7 studies with SWE [ 30 , 46 , 47 , 48 , 49 , 50 , 51 ] and 5 studies with CEUS [ 9 , 30 , 52 , 53 , 54 ].…”

“…Moreover, the pooled sensitivity and specificity for the Micro-US were 0.85 (95% CI 0.76–0.94) and 0.43 (95% CI 0.28–0.59), respectively ( Figures S1 and S2 ). Furthermore, of the two studies [ 30 , 42 ] that assessed the performance of the mpUS, the sensitivity, specificity, PPV and NPV ranged from 0.81 to 0.97, 0.63 to 0.78, 0.70 to 0.90 and 0.71 to 0.97, respectively. The pooled sensitivity and specificity for the mpUS were 0.87 (95% CI 0.71–1.03) and 0.68 (95% CI 0.54–0.81), respectively ( Figures S3 and S4 ).…”

“… Risk of bias and applicability concerns summary: review authors’ judgements about each domain for each included study [ 9 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. …”

“… Pooled specificity for all modalities combined [ 9 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. …”

“…The following supporting information can be downloaded at: , Figure S1: Pooled sensitivity for Micro-US [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], Figure S2: Pooled specificity for Micro-US [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], Figure S3: Pooled sensitivity for mpUS [ 30 , 42 ], Figure S4: Pooled specificity for mpUS [ 30 , 42 ], Figure S5: Pooled sensitivity for grayscale ultrasound [ 30 , 43 , 44 , 45 ], Figure S6: Pooled specificity for grayscale ultrasound [ 30 , 43 , 44 , 45 ], Figure S7: Pooled sensitivity for SWE [ 30 , 47 , 48 , 49 , 50 , 51 ], Figure S8: Pooled specificity for SWE [ 30 , 47 , 48 , 49 , 50 , 51 ], Figure S9: Pooled sensitivity for CEUS [ 9 , 30 , 52 ,…”