INTRODUCTION: High-resolution micro-ultrasound has the capability of imaging prostate cancer based on detecting alterations in ductal anatomy, analogous to multiparametric magnetic resonance imaging (mpMRI). This technology has the potential advantages of relatively low cost, simplicity, and accessibility compared to mpMRI. This multicenter, prospective registry aims to compare the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of mpMRI with high-resolution micro-ultrasound imaging for the detection of clinically significant prostate cancer. METHODS: We included 1040 subjects at 11 sites in seven countries who had prior mpMRI and underwent ExactVu micro-ultrasound-guided biopsy. Biopsies were taken from both mpMRI targets (Prostate Imaging-Reporting and Data System [PI-RADS] >3 and micro-ultrasound targets (Prostate Risk Identification using Micro-ultrasound [PRIMUS] >3). Systematic biopsies (up to 14 cores) were also performed. Various strategies were used for mpMRI target sampling, including cognitive fusion with micro-ultrasound, separate software-fusion systems, and software-fusion using the micro-ultrasound FusionVu system. Clinically significant cancer was those with Gleason grade group ≥2. RESULTS: Overall, 39.5% were positive for clinically significant prostate cancer. Micro-ultrasound and mpMRI sensitivity was 94% vs. 90%, respectively (p=0.03), and NPV was 85% vs. 77%, respectively. Specificities of micro-ultrasound and MRI were both 22%, with similar PPV (44% vs. 43%). This represents the initial experience with the technology at most of the participating sites and, therefore, incorporates a learning curve. Number of cores, diagnostic strategy, blinding to MRI results, and experience varied between sites. CONCLUSIONS: In this initial multicenter registry, micro-ultrasound had comparable or higher sensitivity for clinically significant prostate cancer compared to mpMRI, with similar specificity. Micro-ultrasound is a low-cost, single-session option for prostate screening and targeted biopsy. Further larger-scale studies are required for validation of these findings.
INTRODUCTION: High-resolution micro-ultrasound has the capability of imaging prostate cancer based on detecting alterations in ductal anatomy, analogous to multiparametric magnetic resonance imaging (mpMRI). This technology has the potential advantages of relatively low cost, simplicity, and accessibility compared to mpMRI. This multicenter, prospective registry aims to compare the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of mpMRI with high-resolution micro-ultrasound imaging for the detection of clinically significant prostate cancer. METHODS: We included 1040 subjects at 11 sites in seven countries who had prior mpMRI and underwent ExactVu micro-ultrasound-guided biopsy. Biopsies were taken from both mpMRI targets (Prostate Imaging-Reporting and Data System [PI-RADS] >3 and micro-ultrasound targets (Prostate Risk Identification using Micro-ultrasound [PRIMUS] >3). Systematic biopsies (up to 14 cores) were also performed. Various strategies were used for mpMRI target sampling, including cognitive fusion with micro-ultrasound, separate software-fusion systems, and software-fusion using the micro-ultrasound FusionVu system. Clinically significant cancer was those with Gleason grade group ≥2. RESULTS: Overall, 39.5% were positive for clinically significant prostate cancer. Micro-ultrasound and mpMRI sensitivity was 94% vs. 90%, respectively (p=0.03), and NPV was 85% vs. 77%, respectively. Specificities of micro-ultrasound and MRI were both 22%, with similar PPV (44% vs. 43%). This represents the initial experience with the technology at most of the participating sites and, therefore, incorporates a learning curve. Number of cores, diagnostic strategy, blinding to MRI results, and experience varied between sites. CONCLUSIONS: In this initial multicenter registry, micro-ultrasound had comparable or higher sensitivity for clinically significant prostate cancer compared to mpMRI, with similar specificity. Micro-ultrasound is a low-cost, single-session option for prostate screening and targeted biopsy. Further larger-scale studies are required for validation of these findings.
Authors: Kristin K Porter; Alex King; Samuel J Galgano; Rachael L Sherrer; Jennifer B Gordetsky; Soroush Rais-Bahrami Journal: Prostate Cancer Prostatic Dis Date: 2019-06-25 Impact factor: 5.554
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Authors: Veeru Kasivisvanathan; Antti S Rannikko; Marcelo Borghi; Valeria Panebianco; Lance A Mynderse; Markku H Vaarala; Alberto Briganti; Lars Budäus; Giles Hellawell; Richard G Hindley; Monique J Roobol; Scott Eggener; Maneesh Ghei; Arnauld Villers; Franck Bladou; Geert M Villeirs; Jaspal Virdi; Silvan Boxler; Grégoire Robert; Paras B Singh; Wulphert Venderink; Boris A Hadaschik; Alain Ruffion; Jim C Hu; Daniel Margolis; Sébastien Crouzet; Laurence Klotz; Samir S Taneja; Peter Pinto; Inderbir Gill; Clare Allen; Francesco Giganti; Alex Freeman; Stephen Morris; Shonit Punwani; Norman R Williams; Chris Brew-Graves; Jonathan Deeks; Yemisi Takwoingi; Mark Emberton; Caroline M Moore Journal: N Engl J Med Date: 2018-03-18 Impact factor: 176.079
Authors: August Sigle; Jakob Michaelis; Dominik Schöb; Matthias Benndorf; Lars Schimmöller; Benedikt Becker; Maximilian Pallauf; Andreas J Gross; Thomas R W Herrmann; Jan-Thorsten Klein; Lukas Lusuardi; Christopher Netsch; Axel Häcker; Jens Westphal; Cordula Jilg; Christian Gratzke; Arkadiusz Miernik Journal: Urologie Date: 2022-08-30