Abstract
Objective
To determine the detection of clinically significant prostate cancer (csPCa) index
lesion using high resolution transrectal micro-ultrasound (MicroUS) applying PRI-MUS
(Prostate Risk Identification using Micro Ultrasound) score v1.0.
Methods
Men who underwent radical prostatectomy following biopsy and MicroUS assessment were
included. MicroUS dynamic cine loops of these patients were retrospectively reviewed
by an experienced radiologist. The radiologist was aware that patients had undergone
radical prostatectomy but was blinded to pathological data. Suspicious sites were
assigned a PRI-MUS score. Radical prostatectomy specimens were examined with the quarter
mount technique. Detection rate of csPCa index lesion [Grade Group (GG) ≥2] by MicroUS
was assessed at a patient level.
Results
Twenty-five participants were included in the analysis. The median age was 65.5 years
(range 56-74). Median PSA was 6.45 ng/dL (range 2-31.72). Two of 25 patients did not
have csPCa (GG1 disease) on radical prostatectomy. MicroUS visualized 20/23 (87%)
of the csPCa index lesions [median length 9 mm (range 1.5- 28.5)]. All identified
lesions were categorized PRIMUS score 4 or 5. The 3 missed index lesions were in the
transition zone [median length 10.5 mm (range 4.5-22.5)]. MicroUS missed 11 non index
csPCa in 9 participants [median length 1.5 mm (range 1.5-10.5)]. Of these, 8 were
GG2, 2 GG3 and 1 GG5. MicroUS identified the csPCa index lesion in all 9 of these
men.
Conclusion
MicroUS showed the high sensitivity (87%) in detecting index lesions in the prostate
gland and identified 100% of index lesions in the peripheral zone.
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References
- Canadian Urological Association recommendations on prostate cancer screening and early diagnosis.Can Urol Assoc J. 2017; 11: 298-309
- Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a Multicenter Clinical Trial of 6,630 Men.J Urol. 1994; 151: 1283-1290
- A comparison of the diagnostic performance of systematic versus ultrasound-guided biopsies of prostate cancer.Eur Radiol. 2006; 16: 927-938
- Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging? A Systematic Review of the Literature.Eur. Urol. 2015; 68: 1045-1053
- MRI-targeted or standard biopsy for prostate-cancer diagnosis.N Engl J Med. 2018; 378: 1767-1777
- Comparison of multiparametric magnetic resonance imaging–targeted biopsy with systematic transrectal ultrasonography biopsy for biopsy-naive men at risk for prostate cancer.JAMA Oncol. 2021; 7: 534
- Prostate MRI: a national survey of Urologist’s attitudes and perceptions.Int Braz J Urol. 2016; 42: 464-471
- The index lesion and the origin of prostate cancer.N Engl J Med. 2009; 361: 1704-1706
- Histological characteristics of the index lesion in whole-mount radical prostatectomy specimens: implications for focal therapy.Prostate Cancer Prostatic Dis. 2011; 14: 46-52
- EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer—2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent.Eur Urol. 2021; 79: 243-262
- 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: 562-569
- Comparison of micro-ultrasound and multiparametric magnetic resonance imaging for prostate cancer: a multicenter, prospective analysis.Can Urol Assoc J. 2020; 15
- Evolution of targeted prostate biopsy by adding micro-ultrasound to the magnetic resonance imaging pathway.Eur Urol Focus. 2021; 7: 1292-1299
- Diagnostic accuracy of microultrasound in patients with a suspicion of prostate cancer at magnetic resonance imaging: a single-institutional prospective study.Eur Urol Focus. 2021; 7: 1019-1026
- Use of high-resolution micro-ultrasound to predict extraprostatic extension of prostate cancer prior to surgery: a prospective single-institutional study.World J Urol. 2022; 40: 435-442
- Use of 29-MHz micro-ultrasound for local staging of prostate cancer in patients scheduled for radical prostatectomy: a Feasibility Study.Eur Urol Open Sci. 2020; 19: 20-23
- High-resolution transrectal ultrasound: Pilot study of a novel technique for imaging clinically localized prostate cancer.Urol Oncol Semin Orig Investig. 2014; 32: 34.e27-34.e32
- A multi-institutional randomized controlled trial comparing first-generation transrectal high-resolution micro-ultrasound with conventional frequency transrectal ultrasound for prostate biopsy.BJUI Compass. 2021; 2: 126-133
- Clinicopathologic features and outcomes of anterior-dominant prostate cancer: implications for diagnosis and treatment.Prostate Cancer Prostatic Dis. 2020; 23: 435-440
- The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma.Am J Surg Pathol. 2020; 44: E87-E99
- The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma.Am J Surg Pathol. 2016; 40: 244-252
- Multiparametric Magnetic Resonance Imaging (MRI) and MRI–transrectal ultrasound fusion biopsy for index tumor detection: correlation with radical prostatectomy specimen.Eur Urol. 2016; 70: 846-853
- Three Tesla Multiparametric Magnetic Resonance Imaging: Comparison of Performance with and without Endorectal Coil for Prostate Cancer Detection, PI-RADSTM version 2 Category and Staging with Whole Mount Histopathology Correlation.J Urol. 2019; 201: 496-502
- Multifocality and prostate cancer detection by multiparametric magnetic resonance imaging: correlation with whole-mount histopathology.Eur Urol. 2015; 67: 569-576
- Detection of individual prostate cancer Foci via multiparametric magnetic resonance imaging.Eur Urol. 2019; 75: 712-720
- Comparison of the diagnostic accuracy of micro-ultrasound and magnetic resonance imaging/ultrasound fusion targeted biopsies for the diagnosis of clinically significant prostate cancer.Eur Urol Oncol. 2019; 2: 329-332
- Evolution of targeted prostate biopsy by adding microultrasound to the magnetic resonance imaging pathway.Eur Urol Focus. 2021; 7: 1292-1299
Article info
Publication history
Published online: July 14, 2022
Accepted:
July 4,
2022
Received:
February 16,
2022
Footnotes
Financial Disclosure: Dr. Klein is a consultant for Exact Imaging. The remaining authors declare that they have no relevant financial interests.
Funding: None.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
