Objective:To investigate the diagnostic value of multimodal ultrasound (MUS) in invasive prostate cancer (PCA) and the analysis of receiver operating characteristic (ROC) curve.Methods:A total of 86 PCA patients who underwent surgical resection and were pathologically confirmed in our hospital from January 2018 to February 2021 were selected as the research subjects. According to pathological Gleason score, they could be divided into two groups: the highly invasive group (Gleason gt;All patients in the low-to-medium invasion group (Gleason 4+3, 40 cases) underwent MUS examination before surgery, including conventional transrectal ultrasound (TRUS) shear wave elastography (SWE) contrast-enhanced ultrasound (CEUS).The difference of parameters between the two groups was compared, and the diagnostic efficacy of PCA in the highly invasive group was analyzed by ROC curve.Results: The TRUS performance of the high invasion group was significantly different from that of the low-medium invasion group (P<0.05), and the TRUS in the high invasion group was mainly diffuse. The SR ratio of SWE in the high invasion group (23.86±13.67) was significantly higher than that in the low-medium invasion group (12.82±11.95), and the difference was statistically significant (P<0.05). The initial intensity and peak intensity of the CEUS parameters of the high invasion group were significantly higher than those of the low-medium invasion group (P<0.05), but there was no significant difference in peak time and peak halving time between the two groups (P>0.05). MUS had the largest area under the ROC curve in the diagnosis of PCa in the high-invasive group, as well as the highest sensitivity and specificity (P<0.05).Conclusion: MUS has a higher diagnostic value for highly aggressive PCa and helps guide the clinical choice of treatment options.