Multiparametric Ultrasound Diagnosis of Focal Prostate Diseases Using Compression Elastography

Background: Timely detection of prostate cancer (PCa) at early stages remains a critical challenge in modern urology. Compression elastography is an innovative ultrasound-based technique that provides qualitative assessment of tissue stiffness via color-coded cartographic mapping. Objective: To evaluate the diagnostic value of multiparametric transrectal ultrasound (TRUS) combined with compression elastography for early and differential diagnosis of prostate focal lesions. Methods: A total of 146 male patients (age range: 48–85 years) were examined using TRUS with simultaneous gray-scale imaging, color/power Doppler mapping, and real-time compression elastography, divided into three groups: BPH (n=47), suspected PCa (n=70), and histologically verified PCa (n=29). MRI was the reference standard in 89 cases. Results: Types 3–4 elastograms (high stiffness) were found in 99.9% of verified PCa cases versus 12.8% of BPH patients (p<0.05). Overall diagnostic sensitivity was 93.1%, specificity 87.2%, and accuracy 90.6%. Conclusions: Multiparametric TRUS with compression elastography is a highly informative non-invasive method for early PCa detection and facilitates appropriate patient selection for targeted biopsy.