Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;17(4):117-120.
doi: 10.5489/cuaj.8094.

Detection of clinically significant prostate cancer by micro-ultrasound-informed systematic biopsy during MRI/micro-ultrasound fusion biopsy

Betty Wang  1 , Stacey Broomfield  1 , Anaïs Medina Martín  2 , Patrick Albers  1 , Christopher Fung  3 , Adam Kinnaird  1   2   4   5   6
Affiliations

Detection of clinically significant prostate cancer by micro-ultrasound-informed systematic biopsy during MRI/micro-ultrasound fusion biopsy

Betty Wang et al. Can Urol Assoc J. 2023 Apr.

Abstract

Introduction: High-resolution micro-ultrasound (microUS) is a novel imaging technique that may visualize clinically significant prostate cancer (csPCa), including those missed by magnetic resonance imaging (MRI ), in real time during prostate biopsy.

Methods: From September 2021 to January 2022, 75 consecutive biopsy-naive men were entered into an observational cohort. All men underwent an MRI /microUS fusion prostate biopsy, completed by a single surgeon using the ExactVU device. At time of biopsy, each biopsy core was given a Prostate Risk Identification using MicroUS (PRI-MUS) score. Anonymized data were entered into a RED Cap database. Cancer detection stratified by Prostate Imaging-Reporting & Data System (PI-RADS ) and PRI-MUS score, and imaging modality was captured. Our primary outcome was the detection rate of csPCa in microUS-informed systematic biopsy cores, taken outside MRI-visible lesions, during MRI /microUS fusion prostate biopsy.

Results: A median of three MRI-targeted and 12 microUS-informed systematic cores were taken per patient. MRI /microUS biopsy detected PCa in 84%, with csPCa detected in 52%. Of the 900 microUS-informed systematic cores, 105 cores were PRI-MUS ≥3 and 795 cores were PRI-MUS ≤2. csPCa was detected in 35% of the PRI-MUS ≥3 cores compared to 10% of the PRI-MUS ≤2 cores (p<0.0001). Detection of csPCa varied by core type: 8% of patients were diagnosed by MRI-targeted cores only, 38% were diagnosed by microUS-informed systematic cores only, and 54% were diagnosed by both.

Conclusions: MicroUS-informed systematic biopsy may be a useful adjunct to MRI, with PRI-MUS ≥3 systematic cores having a 3.5-fold increased risk of csPCa compared to PRI-MUS ≤2 cores.

PubMed Disclaimer

Conflict of interest statement

COMPETING INTERESTS: Dr. Fung is a shareholder in Mikata Health and is currently a councillor (elected physician member) for the College of Physicians and Surgeons of Alberta. Dr. Kinnaird has participated in a clinical trial supported by Exact Imaging (with no overlap with the current paper). The remaining authors do not report any competing personal or financial interests related to this work.

Figures

Figure 1
Figure 1
Cancer detection rates per core by micro-ultrasound (US)-informed systematic biopsies. Overall (light grey) and clinically significant (Gleason grade group [GG] ≥2; dark grey) prostate cancer detection rates per core stratified by prostate risk identification using micro-ultrasound scores (PRI-MUS) during microUS-informed systematic prostate biopsy.
See this image and copyright information in PMC

References

    1. Lovegrove CE, Miah S, El-Shater Bosaily A, et al. Comparison of transrectal ultrasound biopsy to transperineal template mapping biopsies stratified by multiparametric magnetic resonance imaging score in the PROMIS trial. J Urol. 2019;203:100–7. doi: 10.1097/JU.0000000000000455. - DOI - PubMed
    1. Rouvière O, Puech P, Renard-Penna R, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): A prospective, multicenter, paired diagnostic study. Lancet Oncol. 2019;20:100–9. doi: 10.1016/S1470-2045(18)30569-2. - DOI - PubMed
    1. Elkhoury FF, Felker ER, Kwan L, et al. Comparison of targeted vs. systematic prostate biopsy in men who are biopsy naive: The prospective assessment of image registration in the diagnosis of prostate cancer (PAIREDCAP) study. JAMA Surg. 2019;154:811–8. doi: 10.1001/jamasurg.2019.1734. - DOI - PMC - PubMed
    1. Lughezzani G, Maffei D, Saita A, et al. Diagnostic accuracy of micro-ultrasound in patients with a suspicion of prostate cancer at magnetic resonance imaging: A single-institutional prospective study. Eur Urol Focus. 2020;7:1019–26. doi: 10.1016/j.euf.2020.09.013. - DOI - PubMed
    1. Ghai S, Eure G, Fradet V, et al. Assessing cancer risk on novel 29 MHz micro-ultrasound images of the prostate: Creation of the micro-ultrasound protocol for prostate risk identification. J Urol. 2016;196:562–9. doi: 10.1016/j.juro.2015.12.093. - DOI - PubMed