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Detection of Clinically Significant Index Prostate Cancer Using Micro-ultrasound: Correlation With Radical

Matias F Callejas1, Eric A Klein2, Matthew Truong2

  • 1Toronto Joint Department of Medical Imaging, University Health Network - Mt Sinai Hospital - Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.

Urology
|July 17, 2022
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This summary is machine-generated.

High-resolution micro-ultrasound (MicroUS) effectively detects clinically significant prostate cancer (csPCa) index lesions, demonstrating 87% sensitivity. This advanced imaging shows promise for improving prostate cancer diagnosis and risk stratification.

Area of Science:

  • Urology
  • Medical Imaging
  • Oncology

Background:

  • Accurate detection of clinically significant prostate cancer (csPCa) is crucial for effective treatment planning.
  • High-resolution transrectal micro-ultrasound (MicroUS) offers potential for improved visualization of prostate lesions.
  • The Prostate Risk Identification using Micro Ultrasound (PRI-MUS) score aims to standardize lesion assessment.

Purpose of the Study:

  • To evaluate the detection rate of clinically significant prostate cancer (csPCa) index lesions using MicroUS.
  • To assess the performance of the PRI-MUS score (v1.0) in identifying csPCa.
  • To determine the sensitivity of MicroUS in detecting index lesions compared to radical prostatectomy pathology.

Main Methods:

  • Retrospective review of MicroUS dynamic cine loops from 25 men who underwent radical prostatectomy.

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  • An experienced radiologist, blinded to pathology, assigned PRI-MUS scores to suspicious sites.
  • Detection rates of csPCa index lesions (Grade Group ≥2) were compared between MicroUS and surgical specimens.

    • Main Results:

    • MicroUS detected 87% (20/23) of csPCa index lesions, with a median length of 9 mm.
    • All detected lesions were assigned a PRI-MUS score of 4 or 5.
    • MicroUS missed 3 index lesions in the transition zone and 11 non-index csPCa lesions in 9 participants.

    Conclusions:

    • MicroUS demonstrates high sensitivity (87%) for detecting prostate cancer index lesions.
    • The technology achieved 100% detection of index lesions located in the peripheral zone.
    • MicroUS shows significant potential for enhancing the detection and characterization of csPCa.