Abstract: Objective To explore the value of transrectal shear wave elastography (TRSWE) in differentiating benign and malignant prostatic nodules in the elderly patients. Methods Young’s modulus of benign and malignant prostate diseases was compared in 83 patients with prostate diseases who underwent biopsy after TRSWE examination. The relationship between Young’s modulus and Gleason of prostate cancer was analyzed. Results The age, maximum value (Emax), minimum value (Emin) and the average value (Emean) of Young’s modulus of the malignant lesions were higher than those of benign lesions, and the difference was statistically significant (P<0.05). AUC and 95%CI of Emax, Emean and Emin to predict prostate cancer were 0.794 (0.691-0.875), 0.740 (0.632-0.830), and 0.634 (0.521-0.737), respectively. The cutoff value of Emax, Emean and Emin was 69.2 kPa, 50.8 kPa and 30.7 kPa, respectively. The Emax and Emean values in the high-risk group score were higher than those in the low-risk group (Gleason score was 6) and the benign group (all P<0.05). The differences in Emax and Emean between the benign group and low-risk group were not statistically significant, and the difference in Emin among all groups was not statistically significant (all P>0.05). Conclusions TRSWE shows high value in the diagnosis of prostate cancer, and it can also indicate the pathological grade of the tumor and provide an imaging evidence for the formulation of clinical treatment plans for prostate cancer.

Key words: ultrasound, prostate cancer, shear wave elastography, Young’s modulus, Gleason score