Diagnostic Value of Micro-Ultrasound in Identifying Local Recurrence After Radical Prostatectomy

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• Standard transrectal ultrasound (TRUS) has limitations in visualizing the prostate bed for biopsies.
• Detecting local recurrence after radical prostatectomy is challenging with current imaging technologies.

Purpose of the Study:

• To benchmark the performance of high-resolution micro-ultrasound (microUS) against standard TRUS for post-prostatectomy biopsies.
• To evaluate microUS efficacy in detecting local prostate cancer recurrence.

Main Methods:

• Retrospective review of pathology reports from January 2013 to October 2024.
• Comparison of biopsy diagnostic yield and accuracy between microUS and TRUS guided procedures.
• Ground truth for recurrence defined by PSA levels, MRI, and/or PET findings.

Main Results:

• MicroUS-guided biopsies (n=10) showed higher sensitivity (89%) compared to TRUS-guided biopsies (n=14, 43%).
• Median lesion size on MRI was smaller in the microUS cohort (0.9 cm) versus the TRUS cohort (2.5 cm).
• Specificity assessment was limited due to small sample sizes in recurrence-negative patients.

Conclusions:

• MicroUS-guided transrectal biopsies demonstrate superior diagnostic performance for detecting local recurrence post-prostatectomy.
• Further research is warranted to validate these findings and assess microUS performance independently of pre-biopsy imaging.