title: The value of contrast-enhanced transrectal ultrasound in predicting the nature of prostate diseases and the Gleason score of prostate cancer by a subjective blood flow grading scale.
abstract: OBJECTIVE
  To investigate the value of contrast-enhanced transrectal ultrasound (CETRUS) in predicting the nature of prostate diseases and prostate cancer Gleason score.
  
  
  METHODS
  106 patients suspected of prostate cancer were evaluated with CETRUS followed by systematic biopsy. Prostate blood flow of CETRUS was graded using a subjective 5-point scale. The relationships between ultrasound findings and biopsy outcomes, as well as prostate cancer Gleason score were analyzed. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of CETRUS.
  
  
  RESULTS
  Biopsy revealed prostate cancer in 43 of 106 patients. The proportions of malignant histology in the groups with CETRUS scores of 1-5 were 0% (0/10), 8.3% (2/24), 31.7% (13/41), 88.9% (16/18) and 92.3% (12/13), respectively. The rate of prostate cancer with a Gleason score ≥7 in the groups with a CETRUS score of 2-5 were 0% (0/2), 15.4% (2/13), 37.5% (6/16) and 91.7% (11/12), respectively. The blood flow grading scale correlated with pathological outcomes and Gleason score significantly (r = 0.66, p < 0.001; and r = 0.61, p < 0.001, respectively). ROC analysis showed the area under the ROC curve to be 0.87.
  
  
  CONCLUSIONS
  CETRUS-based blood flow grading scale is a reliable tool for predicting the pathological outcome of prostate diseases and prostate cancer Gleason score noninvasively.
authors.affiliation: Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Hong Wei
authors.initials: HW
authors.lastname: Zhao
authors.forename: Jun Hang
authors.initials: JH
authors.lastname: Luo
authors.forename: Hui Xiong
authors.initials: HX
authors.lastname: Xu
authors.forename: Dao Hu
authors.initials: DH
authors.lastname: Wang
authors.forename: Ying Rong
authors.initials: YR
authors.lastname: Lai
authors.forename: Mian Ni
authors.initials: MN
authors.lastname: Chen
authors.forename: Jian Yao
authors.initials: JY
authors.lastname: Lv
authors.forename: Xiao Yan
authors.initials: XY
authors.lastname: Xie
authors.forename: Ming De
authors.initials: MD
authors.lastname: Lu
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
mesh_terms: D000368:Aged; D001706:Biopsy; D001783:Blood Flow Velocity; D003287:Contrast Media / Q000494:pharmacology*; D005189:False Positive Reactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D012372:ROC Curve; D016896:Treatment Outcome; D014465:Ultrasonics; D014463:Ultrasonography; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000379:methods*
chemical_list: D003287:Contrast Media