Detection of Clinically Significant Prostate Cancer Using Micro-Ultrasound vs Magnetic Resonance Imaging/Ultrasound...

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• Prostate cancer diagnosis relies on accurate biopsy techniques.
• Distinguishing between micro-ultrasound-guided biopsy (MB) and MRI/ultrasound fusion-guided biopsy (PFB) is crucial for detecting clinically significant prostate cancer (csPCa).

Purpose of the Study:

• To compare the detection rates of csPCa between MB and PFB in men with MRI-visible lesions.
• To evaluate the performance of these biopsy techniques in various patient subgroups, including biopsy-naïve men and those with anterior lesions.

Main Methods:

• Retrospective analysis of 1119 men undergoing MB (n=767) or PFB (n=352) between 2019-2022.
• Application of inverse probability of treatment weighting to balance baseline characteristics.
• Weighted logistic regression models to compare csPCa detection and multivariable models to identify predictors of csPCa.

Main Results:

• Adjusted analyses revealed higher csPCa detection with MB compared to PFB in combined sampling (45% vs 34%; OR, 1.61; P < .01).
• No significant difference in csPCa detection was found between techniques for targeted biopsies alone or in biopsy-naïve men and those with anterior lesions.
• Gleason upgrading at prostatectomy was more frequent in the PFB group (38% vs 17%; P = .01).

Conclusions:

• MB demonstrated higher csPCa detection in adjusted analyses, but the benefit was not universally consistent.
• Further research is needed to ascertain if the observed differences are due to methodological advantages or context-specific factors.