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A cost-effective, widely available, and practical diagnostic imaging tool for prostate cancer (PCa) localization is still lacking. Recently, the contrast-ultrasound dispersion imaging (CUDI) technique has been developed for PCa localization by quantifying dynamic contrast-enhanced ultrasound (DCE-US) acquisitions. Tissue stiffness is an additional PCa biomarker that can be quantified by ultrasound shear-wave elastography (SWE). In this work, a dedicated preprocessing of 3D DCE-US acquisitions was investigated by using multilinear singular value decomposition (MLSVD), aiming at improving the CUDI performance. Moreover, the diagnostic potential of a multiparametric ultrasound imaging approach combining 3D CUDI features with SWE tissue elasticity for clinically significant (cs)PCa localization was evaluated by comparison with the histopathological outcome of systematic biopsies. In this multiparametric approach, the performance of five classifiers was evaluated and compared for biopsy-region csPCa classification. The classification performance was assessed by the area under the Receiver Operating Characteristics curve (AUC) in a k-fold cross validation fashion comprising sequential floating forward selection of the features. The combination of CUDI features with MLSVD preprocessing and SWE elasticity yielded the best AUC=0.87 for csPCa localization. Our results suggest 3D multiparametric ultrasound imaging approach combing a dedicated preprocessing step to be a useful tool for PCa diagnostics.

Additional file 1: Supporting information including additional methods and figures.

Additional file 1: Figure S1. a Cellular uptake of Zr-TCPP(TPP)/R837@M. b In vitro cell viability of 4T1 cells. Figure S2. 4T1, MDA-MB-468, Hepa1-6, and Bxpc-3 after 8 h incubation with Zr-TCPP(TPP)/R837. Figure S3. CRT exposure. Figure S4. a The ex vivo fluorescence image of major organs and tumour and b quantification analysis of the tissue content of Zr-TCPP(TPP)/R837 and Zr-TCPP(TPP)/R837@M; data are expressed as means ± SD (n = 3). Statistical significance was calculated by one-way ANOVA Tukey's multiple comparisons test. P-value: *P

Additional file 1: Fig. S1. Structural formula and synthesis method of ultra-small Ti-TCPP MOF. Fig. S2. TEM images and DLS measurement of Ti-TCPP MOF in PBS for 21 days (a) and FBS for 7 days (b) at 4 ℃. Scale bar: 50 nm. Fig. S3. XRD pattern of Ti-TCPP MOF in PBS for 21 days at 4 ℃. Fig. S4. TEM images and DLS measurement of Ti-TCPP MOF in PBS (a) and FBS for 3 days (b) at 37 ℃. Scale bar: 50 nm. Fig. S5. TEM images and DLS measurement of Ti-TCPP MOF in PBS after US irradiation (0.5 W cm−2, 1 MHz, 50% duty cycle, 1 min). Scale bar: 50 nm. Fig. S6. N2 adsorption/desorption result of Ti-TCPP MOF. Fig. S7. (a) Power-dependent 1O2 generation after US irradiation under normoxia conditions. (b) A standard curve of H2O2 generation measured by multiscan spectrum. Fig. S8. The PA signal of Ti-TCPP MOF under 680–900 nm pulse laser irradiation in vitro. Fig. S9. Cell viability of Panc02 (a) and hTERT-HPNE (b) cells after incubated with Ti-TCPP MOF for 24 h. Fig. S10. Cell viability of BxPC-3 cells after US irradiation (1 MHz, 50% duty cycle, 1 min) for 24 h. Fig. S11. Detection of ROS generation by DCFH-DA kit in tumor cells. Fig. S12. The quantified levels of Bax/Bcl-2 was analyzed by Image J software. The data were expressed as mean ± S.D. (n = 3). ***P