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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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.