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Updated: Sep 4, 2025
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Comparison of Micro-US and Multiparametric MRI for Prostate Cancer Detection in Biopsy-Naive Men
Sangeet Ghai1, Nathan Perlis1, Chantal Atallah1
1From the Joint Department of Medical Imaging, University Health Network-Sinai Health System-Women's, College Hospital, University of Toronto, Toronto General Hospital, 585 University Ave, 1PMB-292, Toronto, ON, Canada M5G 2N2 (S.G., H.F., M.A.H.); Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada (N.P., S.J., K.C., K.L., A.R.Z., A.F.); Department of Pathology, Laboratory Medicine Program, University Health Network, University of Toronto, Toronto, Canada (C.A., T.H.v.d.K.); Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada (K.L.); Department of Urology, Oakville Trafalgar Memorial Hospital, Toronto, Canada (P.F.I.); and Department of Surgery, University of Toronto, Toronto, Canada (U.J.).
Multiparametric MRI and micro-ultrasound (micro-US) show similar prostate cancer detection rates. MRI pathways allowed more avoided biopsies than micro-US, with most MRI lesions visible on micro-US for real-time biopsy.
Area of Science:
- Radiology
- Urology
- Oncology
Background:
- Multiparametric MRI (mpMRI) enhances detection of clinically significant prostate cancer (csPCa).
- Micro-ultrasound (micro-US) is an emerging technology for csPCa detection.
Purpose of the Study:
- To compare mpMRI and micro-US in detecting csPCa (grade group ≥2).
- To assess the visibility of MRI-identified lesions on micro-US for real-time targeted biopsy.
Main Methods:
- Prospective, single-center trial of biopsy-naive men with suspected prostate cancer.
- Patients underwent both mpMRI and micro-US, followed by blinded interpretation.
- Targeted and systematic biopsies were performed using micro-US.
Main Results:
- Similar csPCa detection rates between MRI (39%) and micro-US (35%) targeted biopsies (P=.22).
- Biopsy avoidance was higher with MRI (34%) compared to micro-US (10%) (P<.001).
- 67% of MRI targets were visible on micro-US, enabling real-time biopsy.
Conclusions:
- mpMRI and micro-US demonstrate comparable prostate cancer detection capabilities.
- MRI pathways facilitate greater biopsy avoidance than micro-US.
- Most MRI-visible lesions are identifiable with micro-US, supporting real-time targeted biopsy.
