Diagnostic accuracy of qualitative and quantitative magnetic resonance imaging-guided contrast-enhanced ultrasound (MRI-guided CEUS) for the detection of prostate cancer: a prospective and multicenter study.

PURPOSE: To evaluate the diagnostic value of MRI-guided contrast-enhanced ultrasound (CEUS) for prostate cancer (PCa) diagnosis, and characteristics of PCa in qualitative and quantitative CEUS. MATERIAL AND METHODS: This prospective and multicenter study included 250 patients (133 in the training cohort, 57 in the validation cohort and 60 in the test cohort) who underwent MRI, MRI-guided CEUS and prostate biopsy between March 2021 and February 2023. MRI interpretation, qualitative and quantitative CEUS analysis were conducted. Multitree extreme gradient boosting (XGBoost) machine learning-based models were applied to select the eight most important quantitative parameters. Univariate and multivariate logistic regression models were constructed to select independent predictors of PCa. Diagnostic value was determined for MRI, qualitative and quantitative CEUS using the area under receiver operating characteristic curve (AUC). RESULTS: The performance of quantitative CEUS was superior to that of the qualitative CEUS and MRI in predicting PCa. The AUC was 0.779 (95%CI 0.70-0.849), 0.756 (95%CI 0.638-0.874) and 0.759 (95%CI 0.638-0.879) of qualitative CEUS, and 0.885 (95%CI 0.831-0.940), 0.802 (95%CI 0.684-0.919) and 0.824 (95%CI 0.713-0.936) of quantitative CEUS in training, validation and test cohort, respectively. Compared with quantitative CEUS, MRI achieved less well performance for AUC 0.811 (95%CI 0.741-0.882, p = 0.099), 0.748 (95%CI 0.628-0.868, p = 0.539) and 0.737 (95%CI 0.602-0.873, p = 0.029), respectively. Moreover, the highest specificity of 80.6% was obtained by quantitative CEUS. CONCLUSION: We developed a reliable method of MRI-guided CEUS that demonstrated enhanced performance compared to MRI. The qualitative and quantitative CEUS characteristics will contribute to improved diagnosis of PCa.

The value of oral contrast ultrasonography in the diagnosis of gastric cancer in elderly patients.

BACKGROUND: This study aims to investigate the value of oral contrast ultrasonography (OCUS) in the diagnosis of gastric cancer in elderly patients. METHODS: OCUS data obtained from patients ≥ 60 years old were retrospectively analyzed and compared with gastroscopy results. RESULTS: Among the 12,716 subjects examined by OCUS, 5021 subjects were ≥ 60 years old, which accounted for 39.48% (5021/12,716). Gastritis, gastric polyp, benign ulcer, and gastric cancer were detected by OCUS in 1099 patients. Among them, 196 patients underwent gastroscopy. Furthermore, ulcerative lesions were detected in 32 patients by OCUS and in 51 patients by gastroscopy, and the coincidence rate was 62.74%. Among these patients, gastric cancer was diagnosed in 18 patients by OCUS with a detection rate of 1.64% (18/1099) and detected in 19 patients by gastroscopy with a diagnostic coincidence rate of 94.73% (18/19). Furthermore, benign ulcer was detected in 14 patients by OCUS and in 32 patients by gastroscopy, and the diagnostic coincidence rate was 43.75% (14/32). CONCLUSION: OCUS helps to timely detect senile gastric cancer and can be used as a suitable technique for the detection of gastric diseases.

[Clinical value of contrast-enhanced ultrasonography in the diagnosis of prostate cancer in patients with different PSA concentrations].

OBJECTIVE: To investigate the clinical value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of prostate cancer in patients with different concentrations of prostate-specific antigen (PSA). METHODS: Based on the PSA concentration, 186 patients were divided into three groups (PSA 4－10 µg/L, 11－20 µg/L, and >20 µg/L) and underwent transrectal CEUS and biopsy. We compared the pathological results with the CEUS features in different groups of patients and performed a statistical analysis on the characteristics of the CEUS manifestations of prostate cancer and benign prostatic lesions. RESULTS: Of the 186 patients, 118 (63.4%) were diagnosed by biopsy with prostate cancer and the other 68 (36.6%) with benign prostatic lesions. The positive rate of CEUS in the diagnosis of prostate cancer was above 95% in all the three groups, significantly higher than that of conventional ultrasound in the PSA 4－10 and >10－20 µg/L groups (P <0.01). CONCLUSIONS: Contrast-enhanced ultrasonography can achieve a high detection rate in the diagnosis of prostate cancer, especially for the patients with a low PSA concentration, and therefore can be used as one of the most valuable diagnostic techniques for this purpose.

Clinical value of ultrasound-guided full-needle path anesthesia in transperineal prostate biopsy: An observational study.

BACKGROUND: The pain sensation in a transperineal prostate biopsy was obvious. This study explored the clinical value of ultrasound-guided full-needle path anesthesia in transperineal prostate biopsy. METHODS: Two hundred patients who underwent ultrasound-guided transperineal prostate biopsy at our department were randomly divided into 2 groups. The control group received routine local infiltration anesthesia, and the experimental group received ultrasound-guided full-needle path anesthesia. Immediately after biopsy, visual analog scoring was used to evaluate pain during the biopsy process. Seven days postbiopsy, telephone follow-up revealed symptoms, such as hematuria and discomfort during urination. The measured data were expressed as x ±â€…s. The 2 groups were compared using the t test, and the differences were statistically significant (P < .05). RESULTS: There were no significant differences in age, prostate-specific antigen (PSA) level, or prostate volume between the 2 groups, and all patients underwent prostate biopsy. The pain score of visual analog score was (2.55 ±â€…0.88), urination discomfort was (1.86 ±â€…0.67) days and hematuria time was (2.87 ±â€…0.91) days in the experimental group after biopsy. In the control group, the pain score of visual analog scale was (4.32 ±â€…0.94), the urination discomfort was (2.3 ±â€…0.77) days, and the hematuria time was (2.85 ±â€…0.83) days. Pain scores and urination discomfort were compared between the 2 groups (P < .01). Pain and urination discomfort associated with prostate biopsy in the experimental group were significantly lower than those in the control group. CONCLUSION: Ultrasound-guided full needle path anesthesia can alleviate pain sensation in patients undergoing transperineal prostate biopsy and has high clinical value.

[The value of high-frequency ultrasound in the diagnosis of duchenne muscular dystrophy in children].

OBJECTIVE: To study the value of high-frequency ultrasound in the diagnosis of duchenne muscular dystrophy diseases (DMD) in children. METHODS: Eight children with DMD were enrolled as DMD group and 10 healthy children as the control group. The echogenicity of the rectus femoris muscle and the gap between the gastrocnemius and soleus muscles in the two groups were detected by high-frequency ultrasound. RESULTS: Compared with the control group, rectus femoris and gastrocnemius muscles in the DMD group showed increased echogenicity and their muscle fibers were arranged irregularly, and the gap between the gastrocnemius and soleus muscles became wilder (P<0.01). CONCLUSIONS: High-frequency ultrasound is valuable in the diagnosis of DMD.

Initial screening of gastric cancer using oral contrast-enhanced trans-abdominal ultrasonography in rural asymptomatic individuals.

BACKGROUND & AIMS: Initial screening for high-risk population of gastric cancer (GC) is needed in rural areas of large-population countries. This study aims to explore the feasibility of applying noninvasive ultrasonography as an initial screening strategy to improve the early diagnosis and prevention of GC. METHODS: Oral contrast-enhanced trans-abdominal ultrasonography (OCTU) was initially applied to screen around 15,000 residents from 24 different rural villages of Changxing Island in Shanghai, China, facilitating the identification of high-risk population for further endoscopy examination. RESULTS: 176 subjects (1.18 %) were initially identified with gastric diseases using OCTU while 14,787 ones (98.93 %) were normal with negative results. 145 out of 176 individuals (82.39 %) took further endoscopy examination, and 16 were diagnosed with GC with biopsy examination, with 9 of them at the early stage. We followed up with the Center for Disease Control and Prevention, and identified another 6 GC cases occurred within one year among OCTU-negative population, serving as an adjustment factor for sensitivity analysis. As a result, with a total of 22 GC cases included in this cohort, the positive predictive rate, the negative predictive value, sensitivity, and specificity were 9.09％, 99.96 %, 75.5 %, and 98.93 %, respectively. CONCLUSIONS: OCTU is feasible, non-invasive, low-cost, and widely acceptable in rural area, thus we proposed that OCTU is practicable to serve as a supplementary screening method to improve the early detection of GC in rural area of China and other developing countries with large population.

Application of oral contrast trans-abdominal ultrasonography for initial screening of gastric cancer in rural areas of China.

BACKGROUND: The present study is aimed at assessing the efficacy of oral contrast trans-abdominal ultrasonography (OCTU) as an initial screening tool for gastric cancer in rural areas of China. METHODS: All subjects that were enrolled from Chongming County, Shanghai, China. Subjects in the symptomatic group underwent both OCTU and gastroscopic biopsy. OCTU was performed by experienced ultrasonic physicians in a blinded fashion. RESULTS: In the symptomatic group, 643 patients were enrolled; diagnoses included low risk diseases gastritis (68.9%), polyps (4.0%) and benign ulcers (8.7%), and high risk diseases intraepithelial neoplasia (1.9%), cancer (15.9%) and other lesions (0.6%). Abnormalities were detected by OCTU in 404 subjects (62.8%). High risk diseases were significantly correlated with objective OCTU parameters, including thickness of stomach wall, loss of stratification and hypoechoic mess. With the cut-off value of thickness being set at 7mm, the sensitivity and specificity of OCTU for detecting high risk diseases were 81.3% and 68.8%, respectively. When cut-off value of risk index based on OCTU parameters was set at 3 points, the sensitivity and specificity were 94.1% and 71.4%, respectively. CONCLUSION: OCTU can detect high risk gastric diseases with high sensitivity and specificity providing an initial screening tool for gastric cancer.