Objective. The aim is to study the different roles of single and joint application of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in prostate malignant tumors. Methods. 72 patients with prostate masses who underwent CEUS and MRI examination in our hospital from October 2021 and March 2022 were enrolled in this research. The differentially diagnostic roles of CEUS, MRI, and CEUS combined MRI for prostate cancer was assessed on basis of pathological findings as the reference standard. The specificity and sensitivity of the joint application for prostate malignant tumors with various prostate-specific antigen (PSA) levels were also evaluated. Results. The sensitivity of CEUS, MRI, and the joint application for prostate cancer were 72.1%, 74.4%, and 90.7%, respectively. Compared with single application, the sensitivity of CEUS combined with MRI was significantly higher. The specificity of MRI, CEUS, and the combination of the two for prostate cancer were 82.8%, 79.3%, and 89.7%, respectively, and the statistical differences for specificity were not found. The area under ROC curve (AUC) of CEUS combined with MRI in prostate malignant tumor diagnosis was obviously more than that of CEUS and MRI ( P < 0.05 ). CEUS combined with MRI has relative high sensitivity in these patients with different levels of PSA. Conclusions. Contrast-enhanced ultrasound combined with MRI can significantly improve the sensitivity and specificity of prostate cancer diagnosis so that patients can be better diagnosed in advance.

Purpose To evaluate the predictive performance of the prostate health index (PHI) and PHI density (PHID), for clinically significant prostate cancer (csPCa) in patients with a PI-RADS score ≤3. Materials and Methods Patients tested for total prostate-specific antigen (tPSA, ≤100 ng/mL), free PSA (fPSA), and p2PSA at Peking University First Hospital were prospectively enrolled. Possible predictive factors of csPCa were analyzed using the receiver operating characteristic (ROC) curve. Results were expressed as area under the curve (AUC) with 95% confidence intervals (CI). The cutoff values of PHI and PHID were determined. Results We enrolled 222 patients in this study. The prevalence of csPCa in the PI-RADS ≤3 subgroup (n=89) was 22.47% (20/89). Age, tPSA, F/T, prostate volume, PSA density, PHI, PHID, and PI-RADS score were significantly associated with csPCa. PHID (AUC: 0.829 [95% CI: 0.717–0.941]) was the best predictor of csPCa. PHID >0.956 was set as the threshold of suspicious csPCa with a sensitivity of 85.00% and a specificity of 73.91%, avoiding 94.44% of unnecessary biopsies but missing 15.00% csPCa. A threshold of PHI ≥52.83 showed the same sensitivity but a rather lower specificity of 65.22% that avoided 93.75% of unnecessary biopsies. Conclusions PHI and PHID have the best predictive performance of csPCa in patients with PI-RADS score ≤3. A threshold value of PHID ≥0.956 may be used as the criterion for biopsy in these patients.

Purpose: The current study aims to explore diagnostic value of the thyroid imaging, reporting and data system (TI-RADS) published by the American College of Radiology (ACR) on different-sized thyroid nodules. Methods: A total of 1183 thyroid nodules were selected from 952 patients with thyroid nodules confirmed by surgical pathology from January 2021 to October 2022. Based on the maximum diameters of the nodules, they were stratified into groups A (≤ 10 mm), B (> 10 mm, < 20 mm) and C (≥ 20 mm). The ultrasonic features of the thyroid nodules in each group were evaluated and scored based on ACR TI-RADS, and the receiver operating characteristic curve (ROC) was plotted to determine the optimal cut-off value for the ACR TI-RADS scores and categories in each group. Finally, the diagnostic efficacy of ACR TI-RADS on different-sized thyroid nodules was analyzed. Results: Among the 1183 thyroid nodules, 340 were benign, 10 were low-risk and 833 were malignant. The scores and categorical levels of malignant thyroid nodules in each group were higher than those of benign ones (P<0.05). The areas under the ROCs (AUCs) plotted based on scores were 0.741, 0.907, and 0.904 respectively in the three groups, and the corresponding optimal cut-off values were > 6 points, > 5 points and > 4 points respectively. While the AUCs of the ACR TI-RADS categories were 0.668, 0.855, and 0.887 respectively in each group, with the optimal cut-off values were all > TR4. Besides, for thyroid nodules of larger sizes, ACR-TIRADS exhibited weaker sensitivity with lower positive prediction value (PPV), but the specificity and negative prediction value (NPV) were both higher, presenting with statistically significant differences (P < 0.05). Conclusion: For thyroid nodules of different sizes, the diagnostic efficacy of ACR TI-RADS varies as well. The system shows better diagnostic efficacy on thyroid nodules of > 10 mm than on those ≤ 10 mm. Considering the favorable prognosis of thyroid microcarcinoma and the low diagnostic efficacy of ACR TI-RADS on it, the scoring and classification of thyroid micro-nodules can be left out in appropriate cases, so as to avoid the over-diagnosis and over-treatment of thyroid microcarcinoma to a certain extent.

Background Papillary thyroid carcinoma (PTC) is the most common thyroid carcinoma, which is prone to cervical lymph node metastasis (CLNM). We aim to analyze the correlation between clinical information, ultrasonic (US) measurements of PTC and CLNM. Methods A total of 1335 patients who underwent thyroidectomy and had pathologically confirmed unifocal PTC were enrolled in the retrospective research. Univariate analysis and logistic analysis were performed to predict CLNM in PTC. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance. Results Univariate analysis showed that gender, age, tumour maximum diameter and volume, cross-sectional and longitudinal aspect ratio were related to CLNM (P<0.05). Logistic analysis showed that gender, age, tumour maximum diameter and volume were independent correlative factors. The ROC curve was established based on the correlative factors screened by regression analysis. The AUC of the tumour maximum diameter and volume was 0.738 and 0.733, respectively. ANOVA variance analysis on positive and negative group, tumour maximum diameter and volume, cross-sectional and longitudinal aspect ratio had statistical significance (P < 0.05). Conclusion Independent correlative factors for CLNM in patients with unifocal PTC were younger age, male, larger tumour. For tumour with larger volume, central, lateral or both lymph node metastasis should be checked in advance, it would rule as a guidance to perform FNA for CLNM before surgery.