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Updated: Aug 6, 2026
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Microultrasound-targeted biopsies in patients with suspected prostate cancer: Diagnostic accuracy and clinical
Isabel Sanz Gómez1, Diego Fernando Carvajal1, Camila Vega1
1Department of Urology, Uros Associats, Barcelona, Spain.
Background:
Microultrasound (microUS) is an emerging imaging modality that enables real-time, high-resolution prostate cancer detection.
Objectives:
To evaluate the diagnostic accuracy and clinical utility of microUS-targeted biopsies for the detection of clinically significant prostate cancer (csPCa) in a real-world cohort of patients with suspected disease.
Materials And Methods:
We retrospectively analyzed 200 patients who underwent transperineal microUS-guided prostate biopsy between January 2022 and December 2024. All procedures were performed using the 29 MHz ExactVu system, applying the PRI-MUS scoring system for lesion characterization. Targeted biopsies were followed by 12-core systematic sampling. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Multivariate logistic regression was conducted to identify predictors of csPCa.
Results:
Prostate cancer was detected in 124 patients (62.1%), with csPCa confirmed in 84 cases (42%). Lesions with PRI-MUS ≥4 were significantly associated with csPCa (P = 0.018), yielding a sensitivity of 93% and NPV of 83%. Among patients with negative or absent multiparametric magnetic resonance imaging (mpMRI) (n = 30), microUS identified csPCa in 16.7%. ISUP grade concordance between targeted biopsies and final prostatectomy specimens was 84.8%. PRI-MUS score emerged as the strongest independent predictor of csPCa (OR: 2.96; P = 0.001). The overall complication rate was 4%, exclusively minor events.
Conclusions:
MicroUS-targeted biopsies demonstrate robust diagnostic performance in identifying csPCa, particularly with PRI-MUS scores ≥4. Its real-time imaging capabilities, broad accessibility, and short learning curve suggest that microUS may serve as a reliable alternative or adjunct to mpMRI in contemporary prostate cancer diagnostic pathways.
