Abstract: Objective To investigate the diagnostic value of shear wave elastography(SWE) combined with biparametric MRI(bpMRI)for clinically significant prostate cancer(csPCa). Methods The clinical data of 172 patients with suspected prostate cancer were collected, and they were divided into csPCa group(n=117) and non-csPCa group(n=55) according to the puncture pathology. The predictive value of SWE parameters including maximum Young's modulus(Emax), mean Young's modulus(Emean), minimum Young's modulus(Emin) and bpMRI score for csPCa at different locations in the subgroups with different prostate volumes were analyzed. Results There were statistically significant differences in age, total prostate specific antigen(tPSA), free prostate specific antigen(fPSA), fPSA-to-tPSA ratio(f/tPSA), prostate specific antigen density(PSAD), prostate volume, lesion location, maximum lesion diameter, bpMRI prostate imaging reporting and date system(PI-RADS) score, and Emax, Emean, Emin in abnormal elasticity regions between csPCa group and non-csPCa group(P<0.05).The results of receiver operating characteristic (ROC) curve analysis showed that the areas under the curve(AUCs) of Emax, Emean, Emin in predicting csPCa at peripheral zone and inner gland in the prostate volume ≥60 mL group were 0.706, 0.698, 0.597 and 0.763, 0.756, 0.642,respectively.And in prostate volume <60 mL group, the AUCs were 0.793, 0.787, 0.695 and 0.808, 0.809, 0.728, respectively. The AUCs of bpMRI PI-RADS score in predicting csPCa at peripheral zone and inner gland in the prostate volume ≥60 mL group and prostate volume <60 mL group were 0.867, 0.896, and 0.775, 0.821, respectively. The AUCs of SWE combined with bpMRI PI-RADS score in predicting csPCa were significantly increased. Conclusions SWE has higher diagnostic performance for csPCa in the subgroup with smaller prostate volume. SWE combined with bpMRI has a certain higher clinical value in the diagnosis of csPCa.

Key words: clinically significant prostate cancer, shear wave elastography, biparametric MRI