[Prostatic high resolution micro-ultrasound (MUS) imaging.]

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• Multiparametric magnetic resonance (mpMRI) has improved prostate cancer (PCa) diagnosis but has limitations including variability, a steep learning curve, and high costs.
• Advancements are needed in PCa diagnostic tools to overcome current limitations.

Purpose of the Study:

• To evaluate the efficacy of high-resolution micro-ultrasound (MUS) as an imaging system for guiding prostate biopsies.
• To compare the diagnostic performance of MUS with mpMRI in detecting clinically significant PCa (csPCa).

Main Methods:

• A retrospective study included 96 patients with suspected PCa undergoing transrectal prostate biopsy guided by MUS.
• A standardized PRI-MUS protocol was used to identify suspicious areas, followed by targeted and systematic biopsies.
• Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for csPCa detection were calculated.

Main Results:

• MUS demonstrated an overall csPCa detection rate of 59.37%.
• For PRI-MUS >3, sensitivity was 82% with 93% NPV, but specificity was 39% and PPV was 19%.
• Compared to mpMRI, MUS showed higher sensitivity (82% vs. 30%) and NPV (93% vs. 88%) for csPCa detection, while mpMRI had higher specificity and PPV.

Conclusions:

• MUS is a cost-effective, user-friendly imaging technique with high efficacy for image-guided prostate biopsies.
• MUS increases the overall PCa detection rate compared to conventional ultrasound.
• MUS offers high sensitivity and NPV for csPCa detection, surpassing mpMRI, though with lower specificity.