Detection of clinically significant index prostate cancer using micro-ultrasound

The search for improved prostate biopsy to diagnose prostate cancer began in earnest in the 1980’s. Multiparametric prostate MRI (mpMRI) fusion biopsy is widely employed and is currently considered the best technology to identify and target abnormalities that may harbor cancer. The higher cost, need for contrast, access issues, patient contraindications and the need for experienced MRI readers and biopsy practitioners are limitations to the MRI-based approaches.

Micro-ultrasound is a newer method of prostate biopsy. One limitation of micro-ultrasound is a tradeoff between resolution and depth. This study used micro-ultrasound prior to radical prostatectomy in patients with biopsy-proven prostate cancer and were able to identify 20 of 23 index lesions confirmed on quarter mount pathology. All three lesions that were missed were located in the transitional zone. Micro-ultrasound demonstrated 100% sensitivity in identifying index lesions in the peripheral zone of the prostate.

High-resolution transrectal micro-ultrasound appears to demonstrate index prostate cancer lesions detection rates that are comparable with the rates demonstrated by mpMRI.

Urology, 2022 Jul 14;[ Epub ahead of print]