Evaluation Of The Clinical Application Of Transrectal Ultrasound Combined With Elastography And Contrast-enhanced Ultrasound In The Diagnosis Of Prostate Cancer

Objective:Retrospective analysis was performed on the cases of transrectal ultrasound-guided prostate biopsy in the department of ultrasound in our hospital to evaluate the clinical value of elastography and contrast-enhanced ultrasound in the diagnosis of prostate cancer.Method:Collecting the information of conventional ultrasound,elastography,contrast-enhanced ultrasound,dynamic procedure of biopsy and corresponding pathological results of patients who received prostate biopsy from October 2016 to November 2019.According to the integrity of retained data,a total of 293 needle biopsy was included in the study.Images above all were reviewed together by two experienced doctors who had worked on ultrasonic diagnosis of prostate.Separated calculating the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of each technique,and building the receiveroperating characteristic curve(ROC)to analyse the value of each technique,then calculating the area under the curve(AUC),and analysing the variance of the AUC.Result:The sensitivity,specificity,PPV,NPV and accuracy of transrectal ultrasound(TRUS)in the diagnosis of prostate cancer were 47%,87%,49%,86% and 79% respectively.These of transrectal real-time elastography(TRTE)were 41%,83%,39%,84% and 74% respectively,of CEUS were 46%,85%,44%,86% and 76% respectively.When TRUS combined with TRTE,the sensitivity,specificity,PPV,NPV and accuracy of were 72%,77%,45%,48% and 78% respectively.TRUS combined CEUS were 74%,79%,48%,92% and 78% respectively.TRUS combined with TRTE and CEUS were 75%,74%,43%,92% and 74% respectively.The AUC of TRUS,TRTE and CEUS was 0.673,0.621 and 0.652,respectively.The AUC of the three combined diagnosis methods(TRUE combined TRET,TRUS combined CEUS and all three combined)were higher than that of the single diagnosis method,which was 0.744,0.765 and 0.762,respectively.Compared with conventional ultrasound,TRUS combined with TRET,CEUS,TRET and CEUS all improved the accuracy,but the differences among the three were not statistically significant.Conclusion:1.TRUS combined with TRTE or CEUS or combination of all three can effectively improve the accuracy of prostate cancer diagnosis.2.There was no significance of the difference between TRUS combined with TRTE,TRUS combined with CEUS and the combined of three ultrasonic techniques in the diagnosis of prostate cancer.3.The combination of three ultrasonic techniques improves the sensitivity of diagnosing prostate cancer,helps to reduce the rate of misdiagnosis,and has important clinical value in guiding prostate biopsy.