To evaluate the clinical value of multimodal ultrasound in the diagnosis of prostate cancer (PCa).

A total of 202 patients with clinically suspected prostate cancer from July 2017 to December 2018 were enrolled and underwent laboratory examinations and transrectal multimodal ultrasonography. According to the surgical pathological results, the patients were divided into either a PCa group or a non-PCa group. Univariate and multivariate logistic regression analyses were used to establish a model of multimodal ultrasonography for diagnosis of PCa and a model of multimodal ultrasonography combined with laboratory tests and clinical data for diagnosis of PCa. The area under the ROC curve was used to compare the diagnostic efficacy of the two new models, laboratory tests, and clinical data for PCa.

Univariate logistic regression analysis showed that two-dimensional ultrasound, color Doppler flow imaging, elastography, contrast agent arrival time, peak intensity, intensity difference, and unit time enhancement intensity were statistically significant in the diagnosis of PCa (χ²=5.89, 13.81, and 44.15; Z=1.55, 2.16, 2.81, and 2.43, respectively; P<0.05). Multivariate logistic regression analysis showed that elastography and intensity difference were independent predictors of PCa diagnosis. Then, a model of multimodal ultrasonography (MUS) score was established. MUS score, laboratory tests, and clinical data were combined to conduct univariate and multivariate logistic regression analyses, which that MUS score, prostate specific antigen density (PSAD), and age were independent predictors of PCa diagnosis. Then, a model of MPA (MUS-PSAD-AGE) score was established. The area under the ROC curve, sensitivity, specificity, positive predictive value, and negative predictive value of MPA score in diagnosing PCa were 0.906, 78.50%, 91.49%, 91.30%, and 78.90%; while those of MUS score, age, and PSAD were 0.773, 53.27%, 92.55%, 89.10%, and 63.50%; 0.847, 76.64%, 89.36%, 89.10%, and 77.10%; and 0.675, 77.57%, 48.94%, 63.40%, and 65.70%, respectively. MPA score is the most effective diagnostic indictor for PCa, which showed significantly higher diagnostic efficiency compared with MUS score, PSAD, and age (Z=8.48, t=-4.45, P<0.05).

Multimodal ultrasonography combined with PSAD and age have high clinical value in the diagnosis of PCa.