Application value of contrast-enhanced ultrasound in prostate cancer biopsy in patients with different prostate specific antigen levels

doi:10.3877/cma.j.issn.1672-6448.2023.03.009

Abstract

Abstract:

Objective

To evaluate the value of contrast-enhanced ultrasound (CEUS) in prostate cancer biopsy in patients with different prostate specific antigen (PSA) levels.

Methods

From October 2017 to July 2021, 593 patients who had elevated serum PSA (≥4 ng/ml) and underwent transperineal prostate biopsy at the First People's Hospital of Jiashan County, Zhejiang Province were enrolled. They were divided into either a conventional ultrasound group (group A, 319 cases) or a CEUS group (group B, 274 cases) based on whether CEUS was performed before biopsy or not. Moreover, the two groups of patients were further divided into 6 subgroups based on serum PSA concentration: subgroup A₁ (141 cases) and subgroup B₁ (108 cases) with a serum PSA concentration of 4-10 ng/ml; subgroup A₂ (108 cases) and subgroup B₂ (92 cases) with a serum PSA concentration more than 10-20 ng/ml; subgroup A₃ (70 cases) and subgroup B₃ (74 cases) with a serum PSA concentration more than 20 ng/ml. The patients in the CEUS group underwent targeted biopsy (TB) combined with systematic biopsy (SB), while the patients in the conventional ultrasound group underwent 10-point SB. The t-test was performed to compare the age, the value of PSA concentration, prostate volume, and PSA density of patients between the two group. The χ² test was performed to compare the detection rate of prostate cancer between different subgroups.

Results

There was no significantly difference between the conventional ultrasound group and the CEUS group in age [(72.38±6.11) years vs (73.26±6.64) years], PSA concentration [(15.98±8.52) ng/ml vs (18.43±9.89) ng/ml], prostate volume [(35.81±17.88) ml vs (34.37±16.56) ml], and PSA density [(0.44±0.37) ng/ml² vs (0.50±0.43) ng/ml²] (P>0.05). Among the 593 patients included, 287 (287/593, 48.4%) had prostate cancer. The detection rate in the conventional group was 44.8% (143/319), and the detection rate in the CEUS group was 52.6% (144/274). There was no significantly difference in the total detection rate of prostate cancer between the conventional ultrasound group [44.8% (143/319)] and the CEUS group [52.6% (144/274)] (P>0.05). The detection rate of prostate cancer in subgroup A₁ [31.9% (45/141)] was significantly lower than that of subgroup B₁ [44.4% (48/108] (χ²=4.10, P=0.043), though the detection rate did not differ significantly between subgroup A₂ [42.6% (46/108)] and subgroup B₂ [47.8% (44/92)] and between subgroup A₃ [74.3% (52/70)] and subgroup B₃ [70.3% (52/74)] (P>0.05).

Conclusion

For patients with a PSA contentration of 4-10 ng/ml, CEUS-TB combined with SB can improve the detection rate of prostate cancer.

Key words: Prostate cancer, Contrast-enhanced ultrasound, Targeted biopsy, Prostate specific antigen

Jianhui Cao, Dong Xu, Bin Feng, Junbiao Zheng, Weiwei Huang. Application value of contrast-enhanced ultrasound in prostate cancer biopsy in patients with different prostate specific antigen levels[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(03): 307-312.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.03.009

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References 19

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组别	例数	年龄（岁）	PSA（ng/ml）	前列腺体积（ml）	PSA密度（ng/ml²）
PSA 4~10 ng/ml
常规A₁组	141	71.93±6.02	6.93±1.51	33.15±13.58	0.17±0.07
造影B₁组	108	71.25±5.94	7.14±1.73	33.54±16.03	0.20±0.09
t值		0.622	0.724	0.145	1.470
P值		0.535	0.470	0.885	0.143
PSA 10~20 ng/ml
常规A₂组	108	70.56±5.75	14.19±2.83	40.62±18.65	0.32±0.15
造影B₂组	92	72.63±5.97	13.98±2.24	37.87±13.26	0.36±0.12
t值		1.647	0.368	0.497	0.881
P值		0.105	0.714	0.621	0.381
PSA＞20 ng/ml
常规A₃组	70	76.01±5.50	37.98±17.34	34.68±16.49	1.09±0.71
造影B₃组	74	73.78±8.19	42.01±18.19	31.18±14.98	1.16±0.85
t值		1.301	0.902	0.874	0.674
P值		0.198	0.371	0.386	0.504
PSA 4~100 ng/ml
常规组	319	72.38±6.11	15.90±8.52	35.81±17.88	0.44±0.37
造影组	274	73.26±6.64	18.43±9.89	34.37±16.56	0.50±0.43
t值		0.022	1.323	0.609	1.484
P值		0.983	0.187	0.543	0.139

组别	例数	年龄（岁）	PSA（ng/ml）	前列腺体积（ml）	PSA密度（ng/ml²）
PSA 4~10 ng/ml
常规A₁组	141	71.93±6.02	6.93±1.51	33.15±13.58	0.17±0.07
造影B₁组	108	71.25±5.94	7.14±1.73	33.54±16.03	0.20±0.09
t值		0.622	0.724	0.145	1.470
P值		0.535	0.470	0.885	0.143
PSA 10~20 ng/ml
常规A₂组	108	70.56±5.75	14.19±2.83	40.62±18.65	0.32±0.15
造影B₂组	92	72.63±5.97	13.98±2.24	37.87±13.26	0.36±0.12
t值		1.647	0.368	0.497	0.881
P值		0.105	0.714	0.621	0.381
PSA＞20 ng/ml
常规A₃组	70	76.01±5.50	37.98±17.34	34.68±16.49	1.09±0.71
造影B₃组	74	73.78±8.19	42.01±18.19	31.18±14.98	1.16±0.85
t值		1.301	0.902	0.874	0.674
P值		0.198	0.371	0.386	0.504
PSA 4~100 ng/ml
常规组	319	72.38±6.11	15.90±8.52	35.81±17.88	0.44±0.37
造影组	274	73.26±6.64	18.43±9.89	34.37±16.56	0.50±0.43
t值		0.022	1.323	0.609	1.484
P值		0.983	0.187	0.543	0.139

	例数	良性病灶	前列腺癌	χ²值	P值
PSA 4~10 ng/ml				4.10	0.043
常规A₁组	141	96（68.1）	45（31.9）
造影B₁组	108	60（55.6）	48（44.4）
PSA＞10~20 ng/ml				0.55	0.458
常规A₂组	108	62（57.4）	46（42.6）
造影B₂组	92	48（52.2）	44（47.8）
PSA＞20 ng/ml				0.28	0.591
常规A₃组	70	18（25.7）	52（74.3）
造影B₃组	74	22（29.7）	52（70.3）
PSA 4~100 ng/ml				3.50	0.060
常规组	319	176（55.2）	143（44.8）
造影组	274	130（47.4）	144（52.6）

	例数	良性病灶	前列腺癌	χ²值	P值
PSA 4~10 ng/ml				4.10	0.043
常规A₁组	141	96（68.1）	45（31.9）
造影B₁组	108	60（55.6）	48（44.4）
PSA＞10~20 ng/ml				0.55	0.458
常规A₂组	108	62（57.4）	46（42.6）
造影B₂组	92	48（52.2）	44（47.8）
PSA＞20 ng/ml				0.28	0.591
常规A₃组	70	18（25.7）	52（74.3）
造影B₃组	74	22（29.7）	52（70.3）
PSA 4~100 ng/ml				3.50	0.060
常规组	319	176（55.2）	143（44.8）
造影组	274	130（47.4）	144（52.6）

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