Diagnostic Value of Multiparametric Transrectal Ultrasound in Patients with Suspected Carcinoma of Prostate: A Tertiary Care Centre Experience

To establish the role of grayscale ultrasonography, shear wave elastography (SWE), and contrast-enhanced ultrasound (CEUS) independently and in combination with multiparametric transrectal ultrasound (mp-TRUS) in detecting peripheral zone prostate cancer (PCa) and to compare the performance of mp-TRUS with multiparametric MRI (mp-MRI), keeping biopsy as the gold standard. Thirty men with clinically suspected PCa were enrolled in this single-center-based prospective study conducted over a period of 1.5 years. All patients underwent mp-MRI, mp-TRUS, and guided biopsy. The mp-MRI and mp-TRUS were conducted and interpreted by two different observers who were blinded to each other's findings. In all patients, biopsy cores were taken from a minimum of 12 predetermined sites with extra cores taken from lesions suspicious on either grayscale ultrasonography, SWE, or CEUS. Malignancy was detected in 19 of our patients on mp-TRUS-guided biopsy. A total of 386 cores were obtained with a positive biopsy rate of 38%. mp-TRUS gave a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 100, 63.63, 82.61, 100, and 86.67%, respectively, while the values for mp-MRI were 94.74, 45.45, 75.00, 83.33, and 76.67%, respectively. The area under the ROC curve for mp-TRUS was 0.818 ± 0.076. This value was higher than that for mp-MRI (0.701 ± 0.083). Performance of mp-TRUS is comparable to that of mp-MRI in diagnosing peripheral zone PCa. By improving the diagnostic yield of grayscale ultrasonography, mp-TRUS also acts as a great guiding tool for targeted biopsies, especially in patients where no lesions are seen on grayscale imaging.