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Objective:To investigate whether radiomics based on ultrasound images can predict lym-phatic metastasis of rectal cancer before surgery.Methods:A total of 80 patients with rectal cancer who underwent endorectal ultrasound (TRUS) and endorectal elastography were confirmed by postoperative pathology in Zhejiang Cancer Hospital from January 2016 to December 2019 were retrospectively analyzed. The general characteristics (gender, age, tumor size, depth of tumor infiltration, tumor location, carcinoembryonic antigen, glycoantigen 199) of the lymph node metastasis group ( n=27) and the non-metastasis group ( n=53) were compared, and the clinical risk factors with statistically significant differences were screened out. The tumor maximum sagittal 2D TRUS images and endorectal elastography were manually outlined, and the radiomics features were extracted using the open source software pyradiomics 3.0.1, and the filtering and embedding methods were used to reduce the dimensionality of the data to select the important features and obtain the best parameters of the model. Then all samples were randomly divided into training and validation sets in the ratio of 8∶2, the models were trained using the best model parameters, which were tested and validated in the validation set, and the predictive efficacy of different models was evaluated according to the ROC curve. Results:The depth of tumor infiltration was statistically significant in predicting whether the lymph nodes metastasized or not (χ 2=11.555, P<0.05), and its area under ROC curve(AUC) value was 0.699. A total of 1 710 features were extracted from sagittal 2D TRUS images and endorectal elastography. After pre-processing and screening, 10 features were strongly correlated with lymph node metastasis status. The 10 features were used to construct the prediction models with AUC values of 0.703, 0.726 and 0.742 for the Logistic Regression Model, Random Forest Model and Support Vector Machine Model, respectively. And the AUC value of the ensemble averaging model in the validation set was 0.734. The imaging-omics prediction model outperformed the prediction model based on statistical analysis of clinical data (AUC: 0.734 vs 0.699, Z=1.984), with a statistically significant difference ( P<0.05). Conclusions:The endorectal ultrasound and endorectal elastography-based radiomics model constructed in this study is better than the model constructed based on statistical analysis of clinical data only, and it is valuable for preoperative lymph node metastasis prediction in rectal cancer.
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Objective:To explore the consistency between modified 12+ X prostate biopsy under transrectal interventional ultrasound and postoperative Gleason score in prostate cancer patients.Methods:A retrospective study was conducted on 312 patients diagnosed with prostate cancer and underwent radical resection at Zhongshan People′s Hospital from January 2020 to December 2022. All patients underwent modified 12+ X prostate biopsy and prostate system biopsy under transrectal interventional ultrasound before surgery. Using the Gleason score of postoperative pathological specimens as the " gold standard", the detection rates of prostate cancer and clinically significant prostate cancer using modified 12+ X prostate biopsy and prostate system biopsy under transrectal interventional ultrasound were compared, and the consistency between the two methods alone or in combination and postoperative Gleason score was compared.Results:Among 312 patients, the positive detection rate of the improved 12+ X puncture biopsy combined with the system puncture biopsy was significantly higher than that of the individual detection (95.51% vs 80.77% vs 76.92%), with a statistically significant difference ( P<0.05). The improved 12+ X puncture biopsy combined with system puncture biopsy showed a clinically significant higher detection rate of prostate cancer in positive patients compared to the two tests alone (94.63% vs 77.78% vs 80.00%), with a statistically significant difference ( P<0.05). There was no statistically significant difference in the detection rate of clinically significant prostate cancer among patients who missed diagnosis, either alone or in combination with biopsy ( P>0.05). The upgrade rate of Gleason score after prostate improvement 12+ X puncture biopsy (25.00%) was significantly lower than that of prostate system puncture (44.17%), which was significantly higher than combined puncture biopsy (11.74%), with a statistically significant difference ( P<0.05). After 312 patients received combined puncture biopsy, urinary retention was found in 14 cases (4.49%), hematuria in 30 cases (9.62%), fever in 28 cases (8.97%), and blood in stool in 18 cases (5.77%). After symptomatic treatment, they basically improved within 3 days after puncture. Conclusions:The combination of modified 12+ X prostate biopsy with systematic biopsy under transrectal interventional ultrasound can improve the detection rate of prostate cancer, and has good consistency with the postoperative Gleason score of prostate cancer patients, which has good clinical application value.
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Prostate cancer is the most common malignant tumor in the male urogenital system. Transrectal ultrasound has become a commonly used method for the diagnosis and biopsy of prostate cancer due to its simplicity, economy, and non radiation. This article will discuss the current application status and progress of traditional transrectal ultrasound, color doppler ultrasound, ultrasound imaging, elastic ultrasound, micro ultrasound, tissue scanning, and multimodal ultrasound in the diagnosis of prostate cancer.
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Objective:To evaluate the value of transrectal ultrasound(TRUS)in diagnosing extramural venous invasion(EMVI) of rectal cancer.Methods:Clinical data of 81 rectal cancer patients were retrospectively analyzed in the People′s Hospital of Inner Mongolia Autonomous Region from January 2015 to December 2021. The extramural vascular sonographic features in these patients were summarized. Based on the postoperative pathology and compared with MRI examination, the efficacy of TRUS for the diagnosis of EMVI in rectal cancer was investigated.Results:①According to the sonographic presentation, extramural vessels of rectal cancer can be divided into the following four types: typeⅠshowed that the mass broke through the muscularis propria of the intestinal wall, and no peripheral vascular shadow was observed; typeⅡshowed that the mass broke through the muscularis propria, surrounded by extraneous vessels with normal diameter, running and blood flow; type Ⅲ showed that the mass broke through the intrinsic muscle layer of the intestinal wall and was surrounded by extramural vessels with abnormally thickened diameters, and blood flow filling defects; type Ⅳ showed a mass that broke through the intrinsic muscular layer, with irregularly dilated vessels outside the peritumoral wall and no blood flow signal in the lumen. ②With type Ⅲ and type Ⅳ as positive signs of EMVI, the diagnosis compliance rate of TRUS was 90.1% (Kappa=0.580, P<0.001), sensitivity was 58.3%, specificity was 95.7%, positive predictive value was 70.0%, negative predictive value was 93.0%, and area under the ROC curve(AUC) was 0.770. The diagnosis compliance rate of MRI was 86.4% (Kappa=0.541, P<0.001), sensitivity was 75.0%, specificity was 88.4%, positive predictive value was 52.9%, negative predictive value was 95.3%, and the AUC was 0.817. The differences in sensitivity and specificity between TRUS and MRI for the diagnosis of rectal cancer EMVI were not statistically significant ( P>0.05), and the differences in the AUC were not statistically significant ( Z=0.447, P=0.655). Conclusions:TRUS is valuable in assessing the extramural vascular status of rectal cancer and is expected to be an effective imaging method for preoperative diagnosis of EMVI.
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Objective:To explore the application value of transrectal ultrasound images classification network model of prostate cancer based on deep learning in the classification of benign and malignant prostate tissue in transrectal ultrasound images.Methods:A total of 1 462 two-dimensional images of transrectal prostate biopsy with clear pathologic results(including 658 images of malignant tumor, 804 images of benign tumor) from 203 patients with suspicious prostate cancer(including 89 cases of malignant tumor, 114 cases of benign tumor) were collected from May 2018 to May 2021 in the First Affiliated Hospital of Jinan University. They were divided into the training database, validation database, and test database. And the training and validation database were used to train and obtain the intelligence-assisted diagnosis network model, and then the test database was used to test the network model and two ultrasound doctors of different ages. With pathologic diagnosis as the gold standard, the diagnostic performance among them was evaluated.Results:①The sensitivity of network model was 66.7% the specificity was 91.9%, the accuracy was 80.5%, the precision(positive predictive value) was 87.1%. The area under the ROC curve was 0.922. ②The accuracy of the junior and senior ultrasound doctors was 57.5%, 62.0%; the specificity was 62.0%, 66.3%; the sensitivity was 51.5%, 56.8%; the precision was 53.1%, 58.1%, respectively. ③The accuracy, sensitivity, specificity, precision of classification: the network model > the ultrasound doctors, the differences were significant( P<0.05); the senior ultrasound doctor>the junior ultrasound doctor, the differences were not significant( P>0.05). Conclusions:The intelligence-assisted diagnosis network model based on deep learning can classify benign and malignant prostate tissue in transrectal ultrasound images, improve the accuracy of ultrasound doctors in diagnosing prostate cancer. It is of great significance to improve the efficiency of screening for patients with high clinical suspicion of prostate cancer.
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Objective:To explore the value of transrectal multimodal ultrasound parameters in monitoring and evaluating the efficacy of endocrine therapy for prostate cancer.Methods:Thirty patients with prostate cancer confirmed by pathology and treated with endocrine therapy in Inner Mongolia Autonomous Region People′s Hospital from November 2019 to May 2021 were selected. The levels of serum prostate specific antigen (PSA), prostate volume, color Doppler parameters, elasticity index and contrast-enhanced ultrasound parameters were measured and recorded before treatment, 1 month and 3 months after treatment. The parameters before and after treatment were statistically analyzed. The correlation between the changes of each index and PSA was analyzed by Spearman correlation analysis.Results:Total prostate specific antigen, free prostate specific antigen, and prostate volume were significantly different before treatment, and 1 month and 3 months after treatment( P<0.05), and the values showed a downward trend with increase of treatment time. There was no significant difference in resistance index before and 1 month after treatment( P>0.05), but decreased significantly 3 months after treatment( P<0.05). The values of elasticity index, peak intensity, area under curve and gradient at 1 month and 3 months after treatment were lower than those before treatment, while the arrival time and rising time at 1 month and 3 months after treatment were significantly higher than those before treatment( P<0.05). Spearman correlation analysis showed that there was no correlation between the changes of quantitative parameters and PSA value before and after treatment( P>0.05). Conclusions:Prostate volume, color Doppler parameters, elasticity index, and contrast-enhanced ultrasound parameters change in the early stage of endocrine therapy for prostate cancer, which can be used as a useful supplement to PSA for prostate cancer, and can be used to evaluate the efficacy of clinical prostate cancer endocrine therapy.
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Objective:To compare the values of medical image technologies in evaluating the tansperineal laser ablation (TPLA) in canine prostate.Methods:TPLA (3 W/600 J and 3 W/1 200 J) were operated in the prostate of six adult male beagles guided by transrectal ultrasound (TRUS). TRUS, transrectal contrast-enhanced ultrasound (TR-CEUS) and multiparameter magnetic resonance imaging (mpMRI) were used to evaluate the ablation on the day of TPLA, one week and one month after TPLA. The animals were sacrificed for pathology to calculate the volume of the ablation. SPSS 22.0 software was used for statistical analysis.Results:TRUS could be used to guide and observe the puncture and ablation process during TPLA. TR-CEUS and contrast enhanced MRI showed good consistency in the volume of ablation ( P>0.05). One month after TPLA, the ablation volume were (1.69±0.51)ml vs (1.73±0.36)ml vs (1.52±0.41)ml (3 W/600 J) and (2.23±0.54)ml vs (2.34±0.29)ml vs (2.19±0.34)ml (3 W/1 200 J) measured by the two medical image technologies and pathology, with good consistency ( P>0.05). Conclusions:TRUS can be used to guide and observe the puncture and ablation process during TPLA. TR-CEUS and mpMRI can be used for postoperative evaluation and follow-up of TPLA. The former has advantages of real-time and low price, which can be promoted and applied in clinical practice.
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Objective@#To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).@*Methods@#The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.@*Results@#Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.@*Conclusions@#TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Objective: To explore the value of MRI located and transrectal ultrasound (TRUS)-guided transperineal biopsy of prostate cancer (PCa). Methods: MRI were obtained of 120 patients with suspected PCa, and then systematic biopsy (SB) and MRI-located target biopsy (MRI-TB) guided by TRUS were performed. The detection rate for PCa and positive needle rate of SB, MRI-TB and SB+MRI-TB were respectively calculated according to pathological outcomes. Results: Seventy-eight PCa and 42 benign lesions were proved by pathology. The missed diagnosis rate of SB and MRI-TB for PCa was 23.08% (18/78) and 8.97%(7/78), which were statistically different (P=0.048). The detection rate of PCa for SB, MRI-TB and SB+MRI-TB was 50.00% (60/120), 59.17% (71/120) and 65.00% (78/120), respectively, of SB+MRI-TB was higher than of SB and MRI-TB (both P<0.05). The positive needle rate of PCa for SB, MRI-TB and SB+MRI-TB was 31.17% (374/1 200), 59.58% (286/480) and 35.14% (538/1 531), respectively, of MRI-TB was higher than that of SB and SB+MRI-TB (both P<0.001). Conclusion: MRI-TB can improve the rate of positive biopsy needles, reduce the number of biopsy points and the risk of repeated biopsy and complications. SB+MRI-TB protocol can improve the detection rate of PCa.
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To assess the value of endorectal ultrasonography ( ERUS ) in predicting the pathological response to neoadjuvant chemoradiotherapy( NCRT ) for locally advanced rectal cancer( LARC) . Methods Ninety‐nine patients with LARC received NCRT and total mesorectal excision in our hospital were retrospectively analyzed . T he maximum length and thickness of rectal tumor were measured by ERUS both before NCRT ( ERUS1 ) and after NCRT following sugery ( ERUS2 ) ,and the length and thickness reduction rate were calculated . T he patients were classified into good responder group ( n ＝ 47 ) and poor responder group( n ＝ 52 ) ,or pathological complete response ( pCR) group ( n ＝ 25 ) and non‐pCR group ( n＝74) according to pathological tumor regression grade ( T RG ) . T he differences of various parameters were compared between groups . T he correlations between these parameters and T RG grading were analyzed by Spearman correlation analysis . T he ROC curve was used to evaluate the diagnostic efficacy of the parameter . Results T he length and thickness of ERUS2 were significantly shorter than that of ERUS1( all P ＜0 .05) . T he length and thickness of ERUS2 in good responder group were shorter than those in poor responder group ,while the length and thickness reduction rate were higher than those in poor responder group with significant difference ( all P ＜ 0 .05 ) . T he length and thickness of ERUS2 in pCR group were shorter than those in non‐pCR group ,w hile the length and thickness reduction rate were higher than those in non‐pCR group with significant difference ( all P ＜ 0 .05 ) . T he length and thickness of ERUS2 were positively correlated with T RG grading ( r ＝ 0 .577 ,0 .605 ; all P ＜ 0 .01 ) and the length and thickness reduction rate were negatively correlated with T RG grading ( r ＝ －0 .681 ,－0 .598 ; all P ＜0 .01 ) . ROC curve showed the cut‐off value of the length and thickness reduction rate to predict good responder were 41 .34% ,46 .46% , with corresponding AUC areas of 0 .843 ,0 .796 , sensitivity of 74 .5% ,70 .2% , and specificity of 76 .9% ,80 .8% ,respectively . ROC curve showed the cut‐off value of the length and thickness reduction rate to predict pCR were 57 .36% ,58 .52% ,with corresponding AUC areas of 0 .851 and 0 .895 , sensitivity of 68 .0% ,76 .0% ,and specificity of 94 .6% ,93 .2% ,respectively . Conclusions T he changes of length and thickness of tumor after NCRT are well correlated with treatment response . T he length and thickness reduction rate measured on ERUS present high accuracy in prediction of good response and pCR in LARC patients .
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Objective To explore the diagnostic value of comparing enhanced transvaginal ultrasound (E-TVS),none enhanced transvaginal ultrasound (TVS),and transrectal ultrasound (TRS) in preoperative detection of deep infiltrating endometriosis (DIE) in the rectosigmoid by Meta-analysis.Methods The literatures published from January 1990 to June 2016 were searched.The information of literatures were selected and evaluated.The included data was statistically analyzed by Meta-disc 1.4 software.Results Totally 25 literatures were enrolled.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio were 0.92,0.96,16.64,0.09,227.95 for E-TVS,0.83,0.97,16.95,0.17,112.97 for TVS,0.94,0.96,14.43,0.08,208.72 for TRS,respectively.Area under the curve were 0.980 4,0.966 3,0.979 0,respectively.Conclusion Diagnostic value of the three ultrasonography in preoperative detection of DIE in the rectosigmoid are E-TVS,TRS,TVS.E-TVS can be used as the preferred method of ultrasonic diagnosis of DIE in the rectosigmoid.