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Association Between Contrast-Enhanced Ultrasound Indicators and Prostate Cancer Biochemical Recurrence After Treatment

Authors Mei J, Zhao Y, Jiang Y, Wang J, Yu J

Received 22 February 2020

Accepted for publication 1 June 2020

Published 25 June 2020 Volume 2020:12 Pages 4959—4968


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Xueqiong Zhu

Jiang-jun Mei,1 Yun-xin Zhao,1 Yi Jiang,1 Jian Wang,2 Jia-shun Yu2

1Department of Ultrasound, Shanghai Punan Hospital of Pudong New District, Shanghai, People’s Republic of China; 2Department of Urology, Shanghai Punan Hospital of Pudong New District, Shanghai, People’s Republic of China

Correspondence: Yun-xin Zhao
Department of Ultrasound, Shanghai Punan Hospital of Pudong New District, Room 1602, No. 15, Lane 910, Dingxiang Road, Pudong New District, Shanghai 200135, People’s Republic of China
Tel +86-21-20302000

Background: Some patients with prostate cancer (PCa) will experience biochemical recurrence (BCR) after treatment. Current researches have identified the influencing factors of BCR, but these factors are difficult to quantify and hence unable to accurately predict the BCR in PCa patients.
Objective: To explore the value of contrast-enhanced ultrasound (CEUS) indicators in predicting the BCR after treatment by evaluating the association between them.
Patients and Methods: In a retrospective cohort study, 157 PCa patients were recruited and received prostate specific antigen (PSA) measurement, CEUS, pathological classification, and immunohistochemistry after puncture biopsy. PCa patients with BCR were included in the recurrence group, while the remaining patients were included in the non-recurrence group after a 5-year follow-up. The clinical characteristics and CEUS indicators were compared between the two groups, and the multivariable COX regression was used for screening the influencing factors of BCR. Receiver operating characteristic (ROC) curves were used to analyze the value of potential factors in predicting BCR. The effect of the combined prediction model was explored to improve the accuracy of the prediction.
Results: Twelve patients are lost during the follow-up period and the final analysis included 145 patients. The 5-year BCR rate of PCa patients was 27%, with 43 patients in the recurrence group and 102 patients in the non-recurrence group. Multivariate analysis showed that lymph node metastasis (P< 0.001), distant metastasis (P< 0.001), Gleason score (P< 0.001), pretreatment PSA (P< 0.001), treatment method (P< 0.001), peak intensity (PI) (P=0.001), and time to peak (TTP) (P=0.003) were independent influencing factors for BCR after treatment. ROC analysis showed that the AUCs of all indicators in predicting BCR were not high (all < 0.9). The combination of lymph node metastasis, Gleason score, pretreatment PSA, and treatment method can improve the predictive accuracy (AUC = 0.85), but the AUC was still under 0.9. The combined prediction model including CEUS time-intensity curve (TIC) indicators (PI and TTP) could accurately predict the BCR after treatment (AUC=0.953). The sensitivity and specificity were 93.02% and 88.24%, respectively.
Conclusion: The prediction model including TIC indicators and common influencing factors can more accurately predict the BCR in PCa patients.

Keywords: contrast-enhanced ultrasound, time-intensity curve, prostate cancer, prostate specific antigen, Gleason score, biochemical recurrence

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