Multiparametric ultrasound in the detection of prostate cancer: a systematic review

Arnoud Postema, Massimo Mischi, Jean de la Rosette, Hessel Wijkstra, Arnoud Postema, Massimo Mischi, Jean de la Rosette, Hessel Wijkstra

Abstract

Purpose: To investigate the advances and clinical results of the different ultrasound modalities and the progress in combining them into multiparametric UltraSound (mpUS).

Methods: A systematic literature search on mpUS and the different ultrasound modalities included: greyscale ultrasound, computerized transrectal ultrasound, Doppler and power Doppler techniques, dynamic contrast-enhanced ultrasound and (shear wave) elastography.

Results: Limited research available on combining ultrasound modalities has presented improvement in diagnostic performance. The data of two studies suggest that even adding a lower performing ultrasound modality to a better performing modality using crude methods can already improve the sensitivity by 13-51 %. The different modalities detect different tumours. No study has tried to combine ultrasound modalities employing a system similar to the PIRADS system used for mpMRI or more advanced classifying algorithms.

Conclusion: Available evidence confirms that combining different ultrasound modalities significantly improves diagnostic performance.

Keywords: ANNA/C-TRUS; Contrast-enhanced ultrasound; Doppler; Elastography; Multiparametric MRI; Multiparametric UltraSound; Prostate cancer; Shear wave elastography.

Figures

Fig. 1
Fig. 1
Flow chart. PCa prostate cancer, US ultrasound, NPV negative predictive value, PPV positive predictive value
Fig. 2
Fig. 2
Multiparametric ultrasound and MRI modalities. Top left and right T2-MRI and diffusion-weighted MRI indicating tumour presence on the left side. Middle left and right GSU and elastography indicating tumour presence on the left side. Bottom left and right DCE-US and pathology indicating tumour presence on both sides

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