TRUS-Clinical Nomogram: A Tool for Predicting Bone Metastasis in Prostate Cancer

Area of Science:

• Oncology
• Medical Imaging
• Urology

Background:

• Bone metastasis (BM) is a frequent complication in advanced prostate cancer (PCa).
• Transrectal ultrasound (TRUS) features in PCa patients with BM are not well-understood.
• This study aimed to characterize TRUS findings and develop a risk assessment nomogram for BM in PCa.

Purpose of the Study:

• To identify predictors of bone metastasis (BM) in prostate cancer (PCa) patients.
• To develop and validate a clinical nomogram for assessing BM risk.
• To investigate the role of transrectal contrast-enhanced ultrasound (TR-CEUS) in BM prediction.

Main Methods:

• 114 PCa patients were classified into BM (n=56) and non-BM (n=58) groups based on bone scans.
• Clinical, TRUS, and TR-CEUS data were collected and analyzed using logistic regression.
• A nomogram was built and validated using bootstrap resampling, with performance evaluated by ROC curves, calibration curves, and DCA.

Main Results:

• Multivariate analysis identified elevated T-PSA, higher Gleason score (GS), and TR-CEUS wash-in as independent BM predictors.
• The nomogram demonstrated strong predictive performance with an AUC of 0.899 in the development cohort and 0.859 upon internal validation.
• The model showed satisfactory calibration and significant net clinical benefits.

Conclusions:

• TR-CEUS wash-in is a significant independent predictor of bone metastasis in prostate cancer.
• A nomogram incorporating T-PSA, GS, and TR-CEUS offers a valuable clinical tool for accurate BM risk assessment in PCa patients.