Diagnosis Of Prostate Cancer With Ultrasound And Molecular Imaging

Objective:(1)To establish transrectal ultrasound five-grade scoring system(TRUS-5)based nomograms for the prediction of prostate cancer and high grade prostate cancer at initial biopsy;(2)To evaluate the ability of contrast-enhanced transrectal ultrasound(CETRUS)scanning for prostate cancer detection in different area,compared with conventional transrectal ultrasound(TRUS);(3)To prepare and characterize of bispecific PSMA/GRPr targeting phase-transformation nanoparticles for prostate cancer MR/US dual modal molecular imaging,and to investigate its targeting ability and MR/US imaging behavior in vitro and vivo.Methods:(1)Data were collected from 862 men who underwent initial TRUS-guided 12-core prostate biopsy.After univariate and multivariate logistic regression analyses,nomogram models were developed and internally validated based on independent predictors to predict the probability of prostate cancer and high grade prostate cancer;(2)After examinations of TRUS and CETRUS scanning,228patients underwent TRUS-guided prostate biopsy.Cancer detection between CETRUS and TRUS were compared by patient and by site in different areas;(3)PLGA–PEG nanoparticles(NPs)with Fe₃O₄ NPs and 1H-PFP(1H-PFP/Fe₃O₄@PLGA-PEG-Mal NPs,MP-PS NPs)were prepared using the single emulsification method.The MP-PS NPs were then conjugated with heterodimeric polypeptide through maleimide-thiol click chemistry;we then characterized its(GBP-PS NPs)properties and investigated its targeting ability and MR/US imaging behavior in vitro and vivo.Results:(1)TRUS-5 significantly outperformed TRUS-2 for the risk prediction of prostate cancer and high grade prostate cancer.which demonstrated that TRUS-5 was a better imaging predictor than TRUS-2.Furthermore,we developed TRUS-5 based nomogram models,the predictive accuracy of this nomogram was 90.1%for prostate cancer and 89.4%for high grade prostate cancer in the internal validation,which demonstrated high clinical value;(2)Compared with conventional TRUS,CETRUS could increase the detection rates of overall and significant cancer;CETRUS also had a significant advantage for detecting prostate cancer in different areas.It was most accurate at the base,then mid-gland,and lowest in apex;(3)The GBP-PS NPs had regular shape and good stability,the average diameter was 213.7±65.27 nm and the zeta potential was-33.60±5.34 m V,and it also had good targeting ability and MR/US imaging behavior for prostate cancer in vitro and vivo.Conclusion:(1)Our TRUS-5 based nomogram models performed well for the prediction of prostate cancer and high grade prostate cancer at initial biopsy,which may help to make the decision to biopsy;(2)CETRUS had a significant advantage over conventional TRUS for prostate cancer detection in different areas.CETRUS much more easily missed the cancer in apex,we must focus more on apex and may add other imaging modalities to improve the visualization and detection of prostate cancer;(3)We successful preparated the contrast agent with the function of bispecific targeting and MR/US dual modal molecular imaging,which expected to provide new ideas for accurate detection of prostate cancer.