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Correlation of Prostate High-Resolution Microultrasound With Multiparametric Magnetic Resonance Imaging.

Nicholas A Pickersgill1, Muhammad Hassan Alkazemi1, Adam Ostergar2

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High-resolution microultrasound (microUS) correlates moderately with multiparametric MRI (MP-MRI) for detecting significant prostate cancer. MicroUS improves detection rates, potentially serving as an alternative or adjunct to MRI.

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Area of Science:

  • Urology
  • Radiology
  • Oncology

Background:

  • Multiparametric magnetic resonance imaging (MP-MRI) is standard for prostate cancer detection.
  • High-resolution microultrasound (microUS) offers a complementary imaging approach.
  • Accurate identification of clinically significant prostate cancer (csPCa) is crucial for patient management.

Purpose of the Study:

  • To evaluate the correlation between microUS, using the Prostate Risk Identification using MicroUS (PRI-MUS) protocol, and MP-MRI, assessed by Prostate Imaging Reporting and Data System (PI-RADS) version 2.1.
  • To determine the diagnostic performance of microUS in identifying csPCa lesions.

Main Methods:

  • A prospective database of 267 patients undergoing MP-MRI and microUS-guided biopsy was reviewed.
  • Patients were risk-stratified using the PRI-MUS protocol (PRI-MUS 3-5 positive).
  • Spearman correlation analysis assessed the relationship between PRI-MUS and PI-RADS scores.

Main Results:

  • A moderate positive correlation (r=0.40, P<.001) was found between PRI-MUS and PI-RADS.
  • MicroUS-targeted cores identified higher-grade disease in 5.0% of patients.
  • Clinically significant prostate cancer could have been missed in 2.5% of cases without microUS-targeted sampling.

Conclusions:

  • MicroUS, via the PRI-MUS protocol, shows moderate correlation with MP-MRI/PI-RADS.
  • MicroUS enhances csPCa detection beyond MRI-targeted biopsy alone.
  • MicroUS is a valuable tool, either combined with MP-MRI or as an alternative for MRI-ineligible patients.