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June 27, 2019 — Journal of Urology



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.

Material and Methods:

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.

Results 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.

Authors: 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

J Urol. 2019 Jun 27:101097JU0000000000000415. doi: 10.1097/JU.0000000000000415

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 .

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