Sweep and Scrutinize: Improving Prostate Cancer Diagnostic Efficacy by Combining Whole‐Gland Contrast‐Enhanced Transrectal Ultrasound with Fixed‐Plane Flash‐Replenishment Imaging

OBJECTIVES: To evaluate whether the addition of whole-gland contrast-enhanced transrectal ultrasound (CETRUS) and fixed-plane flash-replenishment imaging (FRI) to conventional transrectal ultrasound (TRUS) improves the diagnostic efficacy of prostate cancer (PCa) in patients with prostate-specific antigen (PSA) levels of 4.00-20.00 ng/mL. METHODS: A total of 163 patients scheduled for TRUS-guided biopsy due to elevated PSA (4.00-20.00 ng/mL) were enrolled. Each patient underwent conventional TRUS, whole-gland CETRUS, and FRI before biopsy. Detection rates and diagnostic efficacy for PCa were compared among 3 imaging strategies: conventional TRUS alone, the combination of conventional TRUS with whole-gland CETRUS, and the triple combination. RESULTS: < .001) by integrating the complementary diagnostic strengths of whole-gland CETRUS (high positive predictive value (PPV) for rapid/hyperenhancement and diffuse abnormalities) and FRI (high PPV for asymmetric/focal enhancement). CONCLUSION: The triple-modality combination significantly improves PCa detection rate and diagnostic efficacy in patients with PSA levels of 4.00-20.00 ng/mL, offering a valuable alternative when magnetic resonance imaging is contraindicated or unavailable.