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Jawli A, Nabi G, Huang Z. The Performance of Different Parametric Ultrasounds in Prostate Cancer Diagnosis: Correlation with Radical Prostatectomy Specimens. Cancers (Basel) 2024; 16:1502. [PMID: 38672584 PMCID: PMC11047975 DOI: 10.3390/cancers16081502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Prostate cancer is a prevalent cancer among men. Multiparametric ultrasound [mpUS] is a diagnostic instrument that uses various types of ultrasounds to diagnose it. This systematic review aims to evaluate the performance of different parametric ultrasounds in diagnosing prostate cancer by associating with radical prostatectomy specimens. METHODOLOGY A review was performed on various ultrasound parameters using five databases. Systematic review tools were utilized to eliminate duplicates and identify relevant results. Reviewers used the Quality Assessment of Diagnostic Accuracy Results [QUADAS-2] to evaluate the bias and applicability of the study outcomes. RESULT Between 2012 and 2023, eleven studies were conducted to evaluate the performance of the different ultrasound parametric procedures in detecting prostate cancer using grayscale TRUS, SWE, CEUS, and mpUS. The high sensitivity of these procedures was found at 55%, 88.6%, 81%, and 74%, respectively. The specificity of these procedures was found to be 93.4%, 97%, 88%, and 59%, respectively. This high sensitivity and specificity may be associated with the large lesion size. The studies revealed that the sensitivity of these procedures in diagnosing clinically significant prostate cancer was 55%, 73%, 70%, and 74%, respectively, while the specificity was 61%, 78.2%, 62%, and 59%, respectively. CONCLUSIONS The mpUS procedure provides high sensitivity and specificity in PCa detection, especially for clinically significant prostate cancer.
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Affiliation(s)
- Adel Jawli
- Division of Imaging Sciences and Technology, School of Medicine, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK
- Department of Clinical Radiology, Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Ministry of Health, Kuwait City 13001, Kuwait
| | - Ghulam Nabi
- Division of Imaging Sciences and Technology, School of Medicine, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK
| | - Zhihong Huang
- Division of Imaging Sciences and Technology, School of Medicine, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK
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Liu Y, Lu D, Xu G, Wang S, Zhou B, Zhang Y, Ye B, Xiang L, Zhang Y, Xu H. Diagnostic accuracy of qualitative and quantitative magnetic resonance imaging-guided contrast-enhanced ultrasound (MRI-guided CEUS) for the detection of prostate cancer: a prospective and multicenter study. LA RADIOLOGIA MEDICA 2024; 129:585-597. [PMID: 38512615 DOI: 10.1007/s11547-024-01758-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 01/03/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To evaluate the diagnostic value of MRI-guided contrast-enhanced ultrasound (CEUS) for prostate cancer (PCa) diagnosis, and characteristics of PCa in qualitative and quantitative CEUS. MATERIAL AND METHODS This prospective and multicenter study included 250 patients (133 in the training cohort, 57 in the validation cohort and 60 in the test cohort) who underwent MRI, MRI-guided CEUS and prostate biopsy between March 2021 and February 2023. MRI interpretation, qualitative and quantitative CEUS analysis were conducted. Multitree extreme gradient boosting (XGBoost) machine learning-based models were applied to select the eight most important quantitative parameters. Univariate and multivariate logistic regression models were constructed to select independent predictors of PCa. Diagnostic value was determined for MRI, qualitative and quantitative CEUS using the area under receiver operating characteristic curve (AUC). RESULTS The performance of quantitative CEUS was superior to that of the qualitative CEUS and MRI in predicting PCa. The AUC was 0.779 (95%CI 0.70-0.849), 0.756 (95%CI 0.638-0.874) and 0.759 (95%CI 0.638-0.879) of qualitative CEUS, and 0.885 (95%CI 0.831-0.940), 0.802 (95%CI 0.684-0.919) and 0.824 (95%CI 0.713-0.936) of quantitative CEUS in training, validation and test cohort, respectively. Compared with quantitative CEUS, MRI achieved less well performance for AUC 0.811 (95%CI 0.741-0.882, p = 0.099), 0.748 (95%CI 0.628-0.868, p = 0.539) and 0.737 (95%CI 0.602-0.873, p = 0.029), respectively. Moreover, the highest specificity of 80.6% was obtained by quantitative CEUS. CONCLUSION We developed a reliable method of MRI-guided CEUS that demonstrated enhanced performance compared to MRI. The qualitative and quantitative CEUS characteristics will contribute to improved diagnosis of PCa.
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Affiliation(s)
- Yunyun Liu
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China
| | - Dianyuan Lu
- Department of Ultrasound, Chongming Hospital Affiliated to Shanghai University of Health & Medicine Sciences, Shanghai, China
| | - Guang Xu
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China
| | - Shuai Wang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China
| | - Bangguo Zhou
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China
| | - Ying Zhang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China
| | - Beibei Ye
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China
| | - Lihua Xiang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China.
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China.
| | - Yifeng Zhang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China.
- Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Tongji University, Shanghai, 200072, China.
| | - Huixiong Xu
- Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
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Perera RH, Berg FM, Abenojar EC, Nittayacharn P, Kim Y, Wang X, Basilion JP, Exner AA. Ultrasound-mediated drug-free theranostics for treatment of prostate cancer. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.13.555594. [PMID: 37745586 PMCID: PMC10515807 DOI: 10.1101/2023.09.13.555594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Rationale Lipid-shelled nanobubbles (NBs) can be visualized and activated using noninvasive ultrasound (US) stimulation, leading to significant bioeffects. We have previously shown that active targeting of NBs to prostate-specific membrane antigen (PSMA) overexpressed in prostate cancer (PCa) enhances the cellular internalization and prolongs retention of NBs with persistent acoustic activity (~hrs.). In this work, we hypothesized that tumor-accumulated PSMA-NBs combined with low frequency therapeutic US (TUS) will lead to selective damage and induce a therapeutic effect in PSMA-expressing tumors compared to PSMA-negative tumors. Methods PSMA-targeted NBs were formulated by following our previously established protocol. Cellular internalization of fluorescent PSMA-NBs was evaluated by confocal imaging using late endosome/lysosome staining pre- and post-TUS application. Two animal models were used to assess the technique. Mice with dual tumors (PSMA expressing and PSMA negative) received PSMA-NB injection via the tail vein followed by TUS 1 hr. post injection (termed, targeted NB therapy or TNT). Twenty-four hours after treatment mice were euthanized and tumor cell apoptosis evaluated via TUNEL staining. Mice with single tumors (either PSMA + or -) were used for survival studies. Tumor size was measured for 80 days after four consecutive TNT treatments (every 3 days). To test the approach in a larger model, immunosuppressed rabbits with orthotopic human PSMA expressing tumors received PSMA-NB injection via the tail vein followed by TUS 30 min after injection. Tumor progression was assessed via US imaging and at the end point apoptosis was measured via TUNEL staining. Results In vitro TNT studies using confocal microscopy showed that the internalized NBs and cellular compartments were disrupted after the TUS application, yet treated cells remained intact and viable. In vivo, PSMA-expressing tumors in mice receiving TNT treatment demonstrated a significantly greater extent of apoptosis (78.45 ± 9.3%, p < 0.01) compared to the other groups. TNT treatment significantly inhibited the PSMA (+) tumor growth and overall survival significantly improved (median survival time increase by 103%, p < 0.001). A significant reduction in tumor progression compared to untreated control was also seen in the rabbit model in intraprostatic (90%) and in extraprostatic lesions (94%) (p = 0.069 and 0.003, respectively). Conclusion We demonstrate for the first time the effect of PSMA-targeted nanobubble intracellular cavitation on cancer cell viability and tumor progression in two animal models. Data demonstrate that the targeted nanobubble therapy (TNT) approach relies primarily on mechanical disruption of intracellular vesicles and the resulting bioeffects appear to be more specific to target cancer cells expressing the PSMA receptor. The effect, while not lethal in vitro, resulted in significant tumor apoptosis in vivo in both a mouse and a rabbit model of PCa. While the mechanism of action of these effects is yet unclear, it is likely related to a locally-induced immune response, opening the door to future investigations in this area.
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Affiliation(s)
| | - Felipe Matias Berg
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Eric Chua Abenojar
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
| | - Pinunta Nittayacharn
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
| | - Youjoung Kim
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Xinning Wang
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - James P. Basilion
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Agata A. Exner
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
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Alghamdi D, Kernohan N, Li C, Nabi G. Comparative Assessment of Different Ultrasound Technologies in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:4105. [PMID: 37627133 PMCID: PMC10452802 DOI: 10.3390/cancers15164105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The present study aimed to assess the diagnostic test accuracy of different ultrasound scanning technologies in the detection of prostate cancer. A systematic search was conducted using the Cochrane Guidelines for Screening and Diagnostic Tests. We performed a systematic search in the international databases PubMed, Medline, Ovid, Embase and Cochrane Library. Searches were designed to find all studies that evaluated Micro-US, mpUS, SWE and CEUS as the main detection modalities for prostate cancer. This study was registered with Research Registry of systematic review and meta-analysis. The QUADAS-2 tool was utilized to perform quality assessment and bias analysis. The literature search generated 1376 studies. Of these, 320 studies were screened for eligibility, with 1056 studies being excluded. Overall, 26 studies with a total of 6370 patients met the inclusion criteria. The pooled sensitivity for grayscale, CEUS, SWE, Micro-US and mpUS modalities were 0.66 (95% CI 0.54-0.73) 0.73 (95% CI 0.58-0.88), 0.82 (95% CI 0.75-0.90), 0.85 (95% CI 0.76-0.94) and 0.87 (95% CI 0.71-1.03), respectively. Moreover, the pooled specificity for grayscale, CEUS, SWE, Micro-US and mpUS modalities were 0.56 (95% CI 0.21-0.90), 0.78 (95% CI 0.67-0.88), 0.76 (95% CI 0.65-0.88), 0.43 (95% CI 0.28-0.59) and 0.68 (95% CI 0.54-0.81), respectively. In terms of sensitivity, substantial heterogeneity between studies was detected (I2 = 72%, p = 0.000 < 0.05). In relation to specificity, extreme heterogeneity was detected (I2 = 93%, p = 0.000 < 0.05). Some studies proved that advanced ultrasound modalities such as mpUS, Micro-US, shear-wave elastography, contrast enhanced and micro-ultrasound are promising methods for the detection of prostate cancer.
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Affiliation(s)
- Dareen Alghamdi
- Division of Imaging Sciences and Technology, School of Medicine, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK
- Radiology Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Neil Kernohan
- Department of Pathology, Ninewells Hospital, Dundee DD9 1SY, UK;
| | - Chunhui Li
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK;
| | - Ghulam Nabi
- Division of Imaging Sciences and Technology, School of Medicine, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK
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Zhang M, Meng Q, Feng L, Wang D, Qu C, Tian H, Jia J, Gao Q, Wang X. Contrast-enhanced ultrasound targeted versus conventional ultrasound guided systematic prostate biopsy for the accurate diagnosis of prostate cancer: A meta-analysis. Medicine (Baltimore) 2022; 101:e32404. [PMID: 36595877 PMCID: PMC9794341 DOI: 10.1097/md.0000000000032404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Conventional transrectal ultrasonography (TRUS) guided prostate biopsy is the standard method for accurate diagnosis of prostate cancer (PCa). However, the limitations of this technique in terms of missed diagnosis cannot be ignored. Based on previous studies, contrast-enhanced ultrasound (CEUS) may be able to more distinctly detect malignant lesions with increased microvessels. Therefore, to evaluate the diagnostic efficiency and clinical application prospects of CEUS-guided prostate biopsy for patients with suspected PCa, we performed a meta-analysis comparing CEUS-targeted with TRUS-guided systematic biopsy. METHODS A systematic search of PubMed, Web of Science, Embase and CNKI was performed up to March, 2022 for the relevant published studies. After data extraction and quality assessment, meta-analysis was performed using the RevMan 5.3 software. RESULTS The results showed that the overall sensitivity was higher for CEUS targeted biopsy than systematic biopsy (P = .03), so was the accuracy (P = .03). However, significant heterogeneity and inconsistent results from certain subgroup analyses challenged the validity of the results. Meanwhile, CEUS yielded a much higher sensitivity in patients with prostate specific antigen (PSA) level of 4 to 10 ng/mL (P = .007). On the other hand, the positive rate of each core (P < .001) and the detection rate of clinically significant PCa (P = .006) were significantly improved using CEUS. CONCLUSION CEUS showed the advantage of a higher detection rate of clinically significant PCa, which might provide more specific indications for subsequent treatment. More feasible, real-time data are required to confirm our findings.
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Affiliation(s)
- Ming Zhang
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Qingsong Meng
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Lulu Feng
- Institute of Pathology, Shijiazhuang Maternity and Child Heathcare Hospital, Shijiazhuang, Hebei, China
| | - Dongbin Wang
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Changbao Qu
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Hui Tian
- Department of Ultrasound, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Jianghua Jia
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Qinglu Gao
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
| | - Xin Wang
- Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebie, China
- * Correspondence: Xin Wang, Department of Urology, Second Hospital of Hebei Medical University, No. 215, Heping Road, Shijiazhuang, Hebei Province, China (e-mail: )
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Chen D, Niu Y, Chen H, Liu D, Guo R, Yao N, Li Z, Luo X, Li H, Tang S. Three-dimensional ultrasound integrating nomogram and the blood flow image for prostate cancer diagnosis and biopsy: A retrospective study. Front Oncol 2022; 12:994296. [DOI: 10.3389/fonc.2022.994296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundsProstate cancer (PCa) is the second most common male cancer in the world and based on its high prevalence and overwhelming effect on patients, more precise diagnostic and therapeutic methods are essential research topics. As such, this study aims to evaluate the value of three-dimensional transrectal ultrasound (3D-TRUS) in the detection, diagnosis and biopsy of PCa, and to provide a basis for clinical practice of PCa.MethodsRetrospective analysis and comparison of a total of 401 male patients who underwent prostate TRUS in our hospital from 2019 to 2020 were conducted, with all patients having prostate biopsy. Nomogram was used to estimate the probability of different ultrasound signs in diagnosing prostate cancer. The ROC curve was used to estimate the screening and diagnosis rates of 3D-TRUS, MRI and TRUS for prostate cancer.ResultsA total of 401 patients were randomly divided into two groups according to different methods of prostate ultrasonography, namely the TRUS group (251 patients) and the 3D-TRUS group (150 patients). Of these cases, 111 patients in 3D-TRUS group underwent MRI scan. The nomogram further determined the value of 3D-TRUS for prostate cancer. The ROC AUC of prostate cancer detected by TRUS, MRI and 3D-TRUS was 0.5580, 0.6216 and 0.6267 respectively. Biopsy complications were lower in 3D-TRUS group than TRUS group, which was statistically significant (P<0.005).ConclusionsThe accuracy of 3D-TRUS was higher in diagnosis and biopsy of prostate cancer. Meanwhile, the positive rate of biopsy could be improved under direct visualization of 3D-TRUS, and the complications could be decreased markedly. Therefore, 3D-TRUS was of high clinical value in diagnosis and biopsy of prostate cancer.
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Study on the Diagnostic Value of Contrast-Enhanced Ultrasound and Magnetic Resonance Imaging in Prostate Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7983530. [PMID: 35979005 PMCID: PMC9377899 DOI: 10.1155/2022/7983530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Objective The aim is to study the different roles of single and joint application of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in prostate malignant tumors. Methods 72 patients with prostate masses who underwent CEUS and MRI examination in our hospital from October 2021 and March 2022 were enrolled in this research. The differentially diagnostic roles of CEUS, MRI, and CEUS combined MRI for prostate cancer was assessed on basis of pathological findings as the reference standard. The specificity and sensitivity of the joint application for prostate malignant tumors with various prostate-specific antigen (PSA) levels were also evaluated. Results The sensitivity of CEUS, MRI, and the joint application for prostate cancer were 72.1%, 74.4%, and 90.7%, respectively. Compared with single application, the sensitivity of CEUS combined with MRI was significantly higher. The specificity of MRI, CEUS, and the combination of the two for prostate cancer were 82.8%, 79.3%, and 89.7%, respectively, and the statistical differences for specificity were not found. The area under ROC curve (AUC) of CEUS combined with MRI in prostate malignant tumor diagnosis was obviously more than that of CEUS and MRI (P < 0.05). CEUS combined with MRI has relative high sensitivity in these patients with different levels of PSA. Conclusions Contrast-enhanced ultrasound combined with MRI can significantly improve the sensitivity and specificity of prostate cancer diagnosis so that patients can be better diagnosed in advance.
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Gurwin A, Kowalczyk K, Knecht-Gurwin K, Stelmach P, Nowak Ł, Krajewski W, Szydełko T, Małkiewicz B. Alternatives for MRI in Prostate Cancer Diagnostics-Review of Current Ultrasound-Based Techniques. Cancers (Basel) 2022; 14:cancers14081859. [PMID: 35454767 PMCID: PMC9028694 DOI: 10.3390/cancers14081859] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Prostate cancer (PCa) is the most common solid malignant tumor in men worldwide with various clinical manifestations. Due to overdiagnosis and overtreatment of a clinically insignificant disease, multiparametric magnetic resonance imaging is recommended for every patient before performing prostate biopsy. However, the diagnostic pathway currently has many limitations and is still far from ideal. Therefore, further alternatives need to be investigated. As the novel ultrasound-based techniques, such as shear wave elastography, contrast-enhanced ultrasound or high frequency micro-ultrasound are able to, overcome the limitations of magnetic resonance imaging presenting good performance in recent studies, we have summarized and compared the results of each technique in the detection of PCa. Furthermore, we analyzed the future perspectives for ultrasound modalities that may soon significantly improve their diagnostic value. Abstract The purpose of this review is to present the current role of ultrasound-based techniques in the diagnostic pathway of prostate cancer (PCa). With overdiagnosis and overtreatment of a clinically insignificant PCa over the past years, multiparametric magnetic resonance imaging (mpMRI) started to be recommended for every patient suspected of PCa before performing a biopsy. It enabled targeted sampling of the suspicious prostate regions, improving the accuracy of the traditional systematic biopsy. However, mpMRI is associated with high costs, relatively low availability, long and separate procedure, or exposure to the contrast agent. The novel ultrasound modalities, such as shear wave elastography (SWE), contrast-enhanced ultrasound (CEUS), or high frequency micro-ultrasound (MicroUS), may be capable of maintaining the performance of mpMRI without its limitations. Moreover, the real-time lesion visualization during biopsy would significantly simplify the diagnostic process. Another value of these new techniques is the ability to enhance the performance of mpMRI by creating the image fusion of multiple modalities. Such models might be further analyzed by artificial intelligence to mark the regions of interest for investigators and help to decide about the biopsy indications. The dynamic development and promising results of new ultrasound-based techniques should encourage researchers to thoroughly study their utilization in prostate imaging.
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Affiliation(s)
- Adam Gurwin
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
- Correspondence: (A.G.); (B.M.); Tel.: +48-607-728-002 (A.G.); +48-506-158-136 (B.M.)
| | - Kamil Kowalczyk
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
| | - Klaudia Knecht-Gurwin
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Paweł Stelmach
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
| | - Łukasz Nowak
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
| | - Wojciech Krajewski
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
| | - Tomasz Szydełko
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
| | - Bartosz Małkiewicz
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.K.); (P.S.); (Ł.N.); (W.K.); (T.S.)
- Correspondence: (A.G.); (B.M.); Tel.: +48-607-728-002 (A.G.); +48-506-158-136 (B.M.)
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