[Value of nomogram based on the ultrasonographic features of prostatic calcification and varicocele and serological indicators in differential diagnosis of prostate cancer].

OBJECTIVE: To explore the diagnostic performance of the nomogram based on the transabdominal ultrasonographic features of prostatic calcification and varicocele (VC) and serological indicators in differentiating PCa with BPH from simple BPH. METHODS: This retrospective study included 108 cases of PCa with BPH and 317 cases of simple BPH, all pathologically confirmed after surgery from January 2014 to December 2021. Using t test or χ2/Fisher test, we compared the clinicopathologic data, transabdominal ultrasonographic features of prostatic calcification, VC severity and serological indicators between the two groups of patients. We identified the significant independent factors for differentiating PCa with BPH from simple BPH by multivariate logistic regression analysis and constructed a nomogram for visualizing the differential diagnostic performance. RESULTS: There were significant differences in the types and diameters of prostatic calcification, PSA density (PSAD), total PSA (tPSA), VC severity, and serum testosterone level between the two groups (P < 0.05). The types of calcification, PSAD and VC severity were identified as independent factors for differentiating PCa with BPH from simple BPH. Nomogram analysis of the above factors showed a good predicting performance, with an AUC of 0.805, a sensitivity of 83.28% and a specificity of 70.37%. CONCLUSION: Transabdominal ultrasonographic features and types of prostatic calcification, PSAD and VC severity are correlated with the development and progression of PCa. Nomogram analysis of the above factors contributes to the differentiation of PCa with BPH from simple BPH.

Contrast-enhanced ultrasound for differentiating benign from malignant solid small renal masses: comparison with contrast-enhanced CT.

PURPOSE: The study aimed to compare the diagnostic efficiency of contrast-enhanced ultrasound (CEUS) with that of contrast-enhanced computed tomography (CECT) in the evaluation of benign and malignant small renal masses (SRMs) (<4 cm) confirmed by pathology. METHODS: A total of 118 patients with 118 renal masses smaller than 4 cm diagnosed by both CEUS and CECT were enrolled in this study, including 25 benign lesions and 93 malignant lesions. All lesions were confirmed by histopathologic diagnosis after surgical resection. The diagnostic imaging studies of the patients were retrospectively reviewed by two independent ultrasonologists and two independent radiologists blinded to the CT or ultrasound findings and final histological results. All lesions on both CEUS and CECT were independently scored on a 3-point scale (1: benign, 2: equivocal, and 3: malignant). The concordance between interobserver agreement was interpreted using a weighted kappa statistic. The diagnostic efficiency of the evaluation of benign and malignant lesions was compared between CEUS and CECT. RESULTS: All the 118 included lesions were detected by both CEUS and CECT. In CEUS and CECT imaging evaluation of the 118 lesions, the weighted kappa value interpreting the concordance between interobserver agreement was 0.89 (95% CI 0.79-0.98) and 0.93 (95% CI 0.87-0.99), respectively. Both CEUS and CECT demonstrated good diagnostic performance in differential diagnosis of benign and malignant SRMs with sensitivity of 93.5% and 89.2%, specificity of 68% and 76%, PPV of 91.6% and 93.3%, NPV of 73.9% and 65.5%, and AUC of 0.808 and 0.826, respectively. There was no statistically significant difference in any of the diagnostic performance indices between these two methods (P > 0.05). However, the qualitative diagnosis of small papillary renal cell carcinoma (RCC) by CEUS was significantly better than that by CECT (P < 0.05), while there was no significant difference in qualitative diagnostic accuracy on other histotypes of SRMs between CEUS and CECT (P > 0.05). CONCLUSIONS: Both CEUS and CECT imaging modalities are effective for the differential diagnosis of benign and malignant SRMs. Furthermore, CEUS may be more effective than CECT for the qualitative diagnosis of small papillary RCC.