Similar to multiparametric magnetic resonance imaging, multiparametric ultrasound (mpUS) can represent a promising approach for prostate cancer (PCa) imaging. We determined the diagnostic performance of B-mode, shearwave elastography (SWE), contrast-enhanced ultrasound (CEUS) with quantification software, and their combination, mpUS, for clinically significant (cs)PCa localization using radical prostatectomy (RP) histopathology as reference standard.

From May 2017 to July 2017, 50 men with biopsy-proven PCa underwent mpUS before RP in one center. Three readers independently evaluated 12 anatomic regions of interest (ROIs) for the likelihood of csPCa on a five-point Likert scale for all separate US modalities and mpUS. A logistic linear mixed model was used to estimate diagnostic performance for the localization of csPCa (any tumour with Gleason score ≥3+4=7, tumour volume ≥0.5mL, extraprostatic extension or pN1-stage) using Likert score ≥3 and ≥4 as threshold. For index-lesion detection, readers selected the two most suspicious ROIs.

and limitations: 48 men were included in the final analysis. ROI-specific sensitivity of mpUS (Likert ≥3) for csPCa was 74% (95%-CI: 67%-80%), compared to 55% (95%-CI: 47%-63%), 55% (95%-CI: 47%-63%) and 59% (95%-CI: 51% -67%) for B-mode, SWE, and CEUS, respectively. Sensitivity of mpUS was significantly higher for both Likert thresholds and all different csPCa definitions (all p<0.05). mpUS improved detection of index-lesion PCa.

mpUS of the prostate, consisting of B-mode, SWE, and CEUS with parametric maps improved localization and index lesion detection of csPCa in comparison with single US modalities yielding good sensitivity values.

The Journal of urology. 2019 Jun 27 [Epub ahead of print]

Christophe K Mannaerts, Rogier R Wildeboer, Sebastiaan Remmers, Rob A A van Kollenburg, Amir Kajtazovic, Johanna Hagemann, Arnoud W Postema, Ruud J G van Sloun, Monique Roobol, Derya Tilki, Massimo Mischi, Hessel Wijkstra, Georg Salomon

Department of Urology, Amsterdam University Medical Center, University of Amsterdam , Amsterdam , The Netherlands., Department of Electrical Engineering, Eindhoven University of Technology , Eindhoven , The Netherlands., Department of Urology, Erasmus University Medical Center , Rotterdam , The Netherlands., Department of Urology, Jeroen Bosch Ziekenhuis , ‘s Hertogenbosch , The Netherlands., Martini Clinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf , Hamburg , Germany .