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. 2023;76(1):25-32.
doi: 10.5173/ceju.2023.198. Epub 2023 Jan 7.

Diagnostic accuracy and clinical utility of micro-ultrasound guided biopsies in patients with suspected prostate cancer

Nuno Dias  1   2 , Gianmarco Colandrea  1   3 , Francisco Botelho  2 , Lara Rodriguez-Sanchez  1 , Camille Lanz  1 , Petr Macek  1 , Xavier Cathelineau  1
Affiliations

Diagnostic accuracy and clinical utility of micro-ultrasound guided biopsies in patients with suspected prostate cancer

Nuno Dias et al. Cent European J Urol. 2023.

Abstract

Introduction: New technologies to improve quality of prostate biopsies are appearing in clinical practice.We evaluate the performance of a micro-ultrasound device and the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting clinically significant prostate cancer (csPCa).

Material and methods: We retrospectively reviewed data of 139 biopsy- naïve patients with suspicion of prostate cancer, who underwent diagnostic MRI and micro-ultrasonography (microUS), followed by transrectal prostatic biopsy (systematic ±targeted) under local anesthetic. The main objective was to evaluate the performance of the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting csPCa, defined as International Society of Urological Pathology (ISUP) ≥2.

Results: Of all patients, 97 (70%) were found to have PCa, and 62 (45%) having csPCa.Among 100 patients with positive microUS (PRI-MUS score ≥3), 23 (23%) had ncsPCa and 57 (57%) were diagnosed with csPCa (ISUP ≥2); and in 39 patients with negative microUS, 12 (31%) were diagnosed with ncsPCa and 5 (13%) with csPCa.A PRI-MUS score ≥3 presented a sensitivity, specificity, positive predictive value and negative predictive value of 92%, 44%, 57% and 95%, respectively, for the detection of csPCa.The PRI-MUS score had higher areas under the curve than Prostate Imaging Reporting & Data System (PI-RADS) both for targeted (AUC 0.801 vs 0.733) and systematic + targeted (AUC 0.776 vs 0.694) biopsies for csPCa detection.

Conclusions: In our cohort, microUS performed well as a diagnostic tool through an easily implementable scale. MicroUS presented similar sensitivity and higher specificity than MRI in detecting csPCa. Further multicenter prospective studies may clarify its role in prostate cancer diagnosis.

Keywords: diagnosis; prostate cancer; ultrasonography.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Results of prostate targeted biopsy, stratified by imaging results. ISUP – International Society of Urological Pathology; PI-RADS – Prostate Imaging Reporting & Data System; PRI-MUS – Prostate Risk Identification using MicroUltraSound
Figure 2 and 3
Figure 2 and 3
Receiver operating characteristics curves of the ExactVu™ for the detections of clinically significant prostate cancer. Left, for overall biopsy detection [AUC PI-RADS 0.694 (0.607–0.782), PRI-MUS 0.776 (0.700–0.852)]; Right, for targeted biopsy detection [AUC PI-RADS 0.733 (0.646–0.819), PRI-MUS 0.801 (0.726–0.875)]. ExactVu™ – Exact Imaging, Markham, Canada; AUC – area under curve; ROC Curve – receiver operating characteristic curve; PI-RADS – Prostate Imaging Reporting & Data System; PRI-MUS – Prostate Risk Identification using MicroUltraSound
Figure 4
Figure 4
Report of different biopsy strategies’ results by ISUP grading. ISUP – International Society of Urological Pathology; microUS – micro-ultrasonography; MRI – magnetic resonance imaging
See this image and copyright information in PMC

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