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. 2024 Jun;18(6):208-211.
doi: 10.5489/cuaj.8626.

Micro-ultrasound for the detection of clinically significant prostate cancer in biopsy-naive men with negative MRI

Patrick Albers  1 , Jacob Bennett  1 , Moira Evans  1 , Ella St Martin  1 , Betty Wang  1 , Stacey Broomfield  1 , Anaïs Medina Martín  2 , Wendy Tu  3 , Christopher Fung  3 , Adam Kinnaird  1   2   4   5   6
Affiliations

Micro-ultrasound for the detection of clinically significant prostate cancer in biopsy-naive men with negative MRI

Patrick Albers et al. Can Urol Assoc J. 2024 Jun.

Abstract

Introduction: Despite a negative magnetic resonance imaging (MRI), some patients may still harbor clinically significant prostate cancer (csPCa, Gleason grade group ≥2). High-resolution micro-ultrasound (microUS) is a novel imaging technology that could visualize csPCa that is missed by MRI.

Methods: This retrospective review included 1011 consecutive patients biopsied between September 2021 and July 2023 in Alberta, Canada. Among them were 103 biopsy-naive patients with negative MRI (Prostate Imaging Reporting & Data System [PI-RADS] ≤2) undergoing microUS-informed prostate biopsy (n=56) scored using Prostate Risk Identification Using Micro-ultrasound (PRI-MUS) or standard transrectal ultrasound prostate biopsy (n=47). The primary outcome was detection rate of csPCa stratified by biopsy technique and PRI-MUS score.

Results: MicroUS biopsy identified csPCa in 14/56 (25%) compared to standard biopsy in 8/47 (17%) (p=0.33). Patients with lesions PRI-MUS ≥3 had csPCa detected at a higher rate compared to patients with PRI-MUS ≤2 (42% vs. 16%, p=0.03). The csPCa detection rate was significantly different comparing patients with prostate-specific antigen (PSA) density <0.15 and PRI-MUS ≤2 compared to patients with PSA density ≥0.15 and PRI-MUS ≥3 (14% vs. 60%, p=0.02).

Conclusions: MicroUS may aid in the detection of csPCa for patients with negative MRI.

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Conflict of interest statement

COMPETING INTERESTS: Dr. Kinnaird has received grant funding from Exact Imaging for unrelated research studies. The remaining authors do not report any competing personal or financial interests related to this work.

Figures

Figure 1
Figure 1
Detection rates of Gleason grade group ≥2 prostate cancer for MRI-negative patients undergoing transrectal microUS or standard transrectal ultrasound biopsy. GG: Gleason grade group; microUS: micro-ultrasound; MRI: magnetic resonance imaging; PRI-MUS: Prostate Risk Identification using Micro-ultrasound Score; PI-RADS v2.1: Prostate Imaging, Reporting, and Data System; TRUS: transrectal ultrasound.
Figure 2
Figure 2
Detection rates of Gleason grade group ≥2 prostate cancer for MRI-negative patients undergoing microUS biopsy stratified by PSA density and PRI-MUS score. GG: Gleason grade group; PRI-MUS: Prostate Risk Identification using Micro-ultrasound Score; PSA: prostate-specific antigen.
See this image and copyright information in PMC

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