Application Value of Transrectal Shear Wave Elastography Mode Combined with Elastic Modulus in the Diagnosis of Prostate Cancer

Abstract

Objective To explore the value of trans-rectal shear wave elastic mode combined with elastic modulus in the diagnosis of prostate cancer and establish a new method for the evaluation of prostate with trans-rectal shear wave elastography(SWE). Methods The typical findings of trans-rectal ultrasound(US)and SWE in 79 patients with prostate cancer(n=41)and benign prostatic hyperplasia(BPH)(n=38)confirmed by surgery or US-guided biopsy were analyzed retrospectively.Their diagnostic value were evaluated with the pathological results as the golden standards. Results Three or more malignant features detected by conventional trans-rectal US(χ 2=42.5,P<0.001)and asymmetrical SWE mode(χ 2=54.2,P<0.001)showed statistically significant difference in prostate cancer and BPH groups.The elastic modulus of Emean and Emax in the prostate cancer group were(92.8±21.5)and(114.2±29.8)kPa,which were significantly higher than those in the BPH group [(56.7±14.0)(t=-8.8,P<0.001)and(68.4±17.2)kPa(t=-8.3,P<0.001)].The receiver-operating characteristic(ROC)curve with Logistic regression showed that the elastic model combined elastic modulus had the largest area under ROC curve and the highest diagnosis efficiency of prostate cancer,with the cutoff value of 0.45.The diagnosis sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the combination were 95.1%,89.5%,90.7%,94.4%,and 92.4%,respectively. Conclusion Combination of SWE mode and elastic modulus is more valuable than elastic modulus alone in the diagnosis of prostate cancer.