Microultrasound as good as MRI for detection of prostate cancer: Study
Canada: The detection rate of micro-ultrasound is comparable to multiparametric MRI in biopsy-naive men, shows a recent study in the journal Radiology.
According to the study, similar rates of prostate cancer detection were seen with MRI and micro-ultrasound in men who have not yet been biopsied, but with the MRI pathway, more biopsies were avoided than with micro-US. Also, there was no benefit of nontargeted systematic biopsy addition to the MRI- plus micro-US–targeted biopsy pathway.
Previous studies have shown that multiparametric MRI increased the detection of clinically significant prostate cancer (csPCa). For csPCa detection, micro-US is being investigated. Considering this, Sangeet Ghai, University of Toronto, Toronto, ON, Canada, and colleagues aimed to compare multiparametric MRI and micro-US for csPCa (grade group ≥2) detection and to determine the proportion of MRI nodules visible at micro-US for real-time targeted biopsy in a prospective, single-center trial.
The trial enrolled biopsy-naive men with suspected prostate cancer (PCa) between May 2019 and September 2020. All patients underwent multiparametric MRI followed by micro-US. Interpretation of the findings was done in a blinded fashion, followed by targeted biopsy and nontargeted systematic biopsy using micro-US. The exact McNemar test was used to compare the proportions. The differences in proportions were calculated.
The findings of the study were as follows:
· Ninety-four men (median age, 61 years) were included. MRI- and micro-US–targeted biopsy depicted csPCa in 39% and 35% of the 94 men, respectively; clinically insignificant PCa in 15% and 16%; and cribriform and/or intraductal PCa in 15% and 14%.
· The MRI- plus micro-US–targeted biopsy pathway depicted csPCa in 38 of the 94 men.
· The addition of nontargeted systematic biopsy to MRI- plus micro-US–targeted biopsy did not enable the identification of any additional men with csPCa but did help identify nine additional men with clinically insignificant PCa.
· Biopsy was avoided in 32 of the 94 men (34%) with MRI and nine of the 94 men (10%) with micro-US.
· Among 93 MRI targets, 62 (67%) were prospectively visible at micro-US.
To conclude, in biopsy-naive men, multiparametric MRI and micro-US showed similar prostate cancer detection rates; although micro-US was inferior to multiparametric MRI for biopsy avoidance, most MRI lesions were visible at micro-US.
Reference:
The study titled, "Comparison of Micro-US and Multiparametric MRI for Prostate Cancer Detection in Biopsy-Naive Men." was published in the journal Radiology.
DOI: https://doi.org/10.1148/radiol.212163
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