Objective:

To investigate the clinical value of prostate-specific antigen density (PSAD)

transrectal real-time tissue elastography (TRTE) combined with multiparametric magnetic resonance imaging (mpMRI)

in the treatment of prostate cancer in the grey area of PSA.

Methods:

A total of 151 suspected prostate cancer patients with PSA of 4-10 ng/mL (PSA gray area) in Kunshan Hospital of Traditional Chinese Medicine were collected and all received PSA test

TRTE and mpMRI. The differences in age

PSA

TRTE score and MRI Prostate Imaging Reporting and Data System (PI-RADS) score between prostate cancer group and benign hyperplasia group were compared. Receiver operating characteristic (ROC) curve was constructed to analyze the diagnostic efficacy of single indicators (PSAD

TRTE score and MRI PI-RADS score) and combined diagnosis for prostate cancer in the grey area of PSA.

Results:

There were significant differences in PSAD

TRTE scores and PI-RADS scores between the two groups (

Z

=4.92

5.97

6.81

all

P

＜0.001). The ROC curves of PSAD

TRTE scores

PI-RADS scores and their combined diagnosis were constructed

and the area under curve (AUC) values were 0.749

0.79

0.832 and 0.901

respectively. The combined diagnosis efficiency of the three was the highest

and the difference was statistically significant (

Z

=3.89

2.70

3.99

all

P

＜0.01).

Conclusion:

PSAD

TRTE score and MRI PI-RADS score have high diagnostic value for prostate cancer in grey area of PSA. PSAD

TRTE score combined with MRI PI-RADS score can significantly improve the accuracy of prostate cancer in the grey area of PSA

and avoid many unnecessary biopsies in clinical work.