Department of Ultrasound, Inner Mongolia People's Hospital, Hohhot, 010017, China.
Department of Ultrasound, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, 010017, China.
Cancer Imaging. 2022 Oct 18;22(1):60. doi: 10.1186/s40644-022-00498-8.
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).
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.
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.
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.
评估多参数超声（mpUS）和多参数磁共振成像/经直肠超声（mpMRI-TRUS）融合在检测临床显著前列腺癌（csPCa）中的联合疗效。
2019 年 11 月至 2021 年 9 月，对未经活检的患者进行 mpMRI-TRUS 融合成像联合 mpUS 引导靶向活检（TB）和系统活检（SB）。为了进一步评估 mpUS 的附加诊断价值，评估了融合成像获得的 202 个焦点的影像学特征。比较了 mpMRI-TRUS 融合成像和 mpMRI-TRUS 融合成像与 mpUS 联合检测 csPCa 的诊断准确性。
共纳入 202 例前列腺病变（160 例患者）进行最终分析，其中 105 例为 csPCa，16 例为 ciPCa，81 例为非癌性病变。中位患者年龄为 69（65-73）岁，中位 tPSA 为 22.07（11.22-62.80）ng/ml。对于 csPCa，TB 的检出率高于 SB（50.0% vs. 45.5%，p<0.05）。mpUS 对 PCa 和非 PCa 组的影像学特征有显著差异（p<0.001）。与 mpMRI-TRUS 融合成像相比，mpMRI-TRUS 融合成像联合 mpUS 对 csPCa 诊断的阳性预测值、假阳性率和曲线下面积（AUC）分别提高了 11.30%、降低了 19.58%、从 0.719 增加到 0.770（p<0.05）。
TB 可提高 csPCa 的检出率，因此可有效用于 csPCa 的诊断和风险评估。mpUS 丰富了 mpMRI-TRUS 融合成像的有价值的诊断信息，两者联合对 csPCa 具有更高的诊断价值，可指导后续临床治疗。
