Avolio, PP;
Piccolini, A;
Saitta, C;
Fasulo, V;
Maffei, D;
Moretto, S;
Cella, L;
... Lughezzani, G; + view all
(2025)
Enhanced diagnostic accuracy of micro-ultrasound in prostate cancer detection: An updated series from a single-center prospective study.
Urologic Oncology: Seminars and Original Investigations
, 41
(8)
470.e19-470.e26.
10.1016/j.urolonc.2025.03.012.
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Abstract
Introduction: Multiparametric (mp) magnetic resonance imaging (MRI) is essential for prostate cancer (PCa) detection but is limited by availability, cost, and complexity. Micro-ultrasound (microUS) offers real-time, high-resolution imaging and may enhance clinically significant (cs) prostate cancer (PCa) detection when used with mpMRI. This study updates the diagnostic performance of microUS compared to mpMRI in a large prospective cohort. Materials and Methods: We prospectively enrolled 1, 423 men with suspected PCa between October 2017 and April 2024. All patients underwent imaging with the ExactVu system, followed by both microUS-targeted and MRI-targeted biopsies. The primary outcome was the accuracy of detecting csPCa, defined as Gleason score ≥3 + 4 (International Society of Urological Pathology Grade Group ≥2), comparing microUS, mpMRI, and their combined use. Results: CsPCa was diagnosed in 116 (36.3%) patients. MicroUS detected lesions in 1, 076 out of 1, 423 patients (76%) of patients, with a sensitivity of 85% and a negative predictive value of 79% for csPCa. Concordance between microUS and mpMRI findings was 96%. In total, 252 patients (18%) were diagnosed with PCa solely on targeted cores. Among these, 25 csPCa cases were identified exclusively by microUS-targeted and 4 by MRI-targeted biopsies. However, systematic biopsies still identified 22% of csPCa cases missed by both targeted approaches. Conclusion: MicroUS, especially when combined with mpMRI, significantly enhances csPCa detection. This combined imaging approach may reduce the need for systematic biopsies. Further advancements in microUS technology could refine its diagnostic utility.
| Type: | Article |
|---|---|
| Title: | Enhanced diagnostic accuracy of micro-ultrasound in prostate cancer detection: An updated series from a single-center prospective study |
| DOI: | 10.1016/j.urolonc.2025.03.012 |
| Publisher version: | https://doi.org/10.1016/j.urolonc.2025.03.012 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Prostate cancer, Micro-ultrasound, mpMRI, Targeted biopsy, Diagnostic accuracy, Clinically significant prostate cancer. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10211109 |
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