Chang Ying, Yang Jingchun, Hong Hua, Ma Huijuan, Cui Xin, Chen Li
1Departments of Ultrasonography, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China.
2Departments of Ultrasonography, Inner Mongolia Autonomous Region People's Hospital, Hohhot 010017, China.
Aging Dis. 2018 Jun 1;9(3):480-488. doi: 10.14336/AD.2017.0704. eCollection 2018 Jun.
To evaluate the performance of a combination of real-time strain elastography (RTSE) and contrast-enhanced transrectal ultrasound (CETRUS) for prostate cancer detection. Patients with serum prostate-specific antigen (PSA) levels of ≥4.0 ng/ml were prospectively enrolled between June 2014 and December 2016. 153 prostate nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CETRUS and RTSE before a biopsy. Multivariate logistic regression models were established for CETRUS, and CETRUS combined with RTSE to diagnose prostate malignancy. The diagnostic performances of CETRUS, RTSE, and their combined use were evaluated with the receiver operating characteristic (ROC) curve. The multivariate logistic regression for CETRUS combined with RTSE showed that enhanced strength, enhanced uniformity, and elasticity scores were the independent predictors of prostate malignancy. The area under the ROC curve of CETRUS combined with RTSE (0.921±0.023) was higher than that of CETRUS and RTSE (0.88±0.029 and 0.80±0.038, respectively; both <0.05). Moreover, the sensitivity, accuracy and negative predictive value of CETRUS combined with RTSE were 92.1%, 86.2%, and 84.6%, respectively. The omission diagnostic rate of CETRUS combined with RTSE (7.9%) was reduced. And the diagnostic accuracy of CETRUS combined with RTSE was significantly higher than that of CETRUS and RTSE (<0.05). While the diagnostic accuracy of CETRUS was close to the RTSE, the difference was not statistically significant (>0.05). The combined RTSE with CETRUS approach significantly improved the sensitivity and overall accuracy for correctly identifying prostate cancer.
评估实时应变弹性成像（RTSE）与超声造影经直肠超声检查（CETRUS）联合应用于前列腺癌检测的性能。2014年6月至2016年12月期间，前瞻性纳入血清前列腺特异性抗原（PSA）水平≥4.0 ng/ml的患者。对153个经传统超声诊断的前列腺结节进行前瞻性纳入，并在活检前通过CETRUS和RTSE进行检查。建立CETRUS以及CETRUS联合RTSE诊断前列腺恶性肿瘤的多变量逻辑回归模型。采用受试者操作特征（ROC）曲线评估CETRUS、RTSE及其联合应用的诊断性能。CETRUS联合RTSE的多变量逻辑回归显示，增强强度、增强均匀性和弹性评分是前列腺恶性肿瘤的独立预测因素。CETRUS联合RTSE的ROC曲线下面积（0.921±0.023）高于CETRUS和RTSE（分别为0.88±0.029和0.80±0.038；均<0.05）。此外，CETRUS联合RTSE的敏感性、准确性和阴性预测值分别为92.1%、86.2%和84.6%。CETRUS联合RTSE的漏诊率（7.9%）降低。CETRUS联合RTSE的诊断准确性显著高于CETRUS和RTSE（<0.05）。虽然CETRUS的诊断准确性与RTSE接近，但差异无统计学意义（>0.05）。RTSE与CETRUS联合应用方法显著提高了正确识别前列腺癌的敏感性和总体准确性。
