Diagnostic Accuracy of Microultrasound in Patients with a Suspicion of Prostate Cancer at Magnetic Resonance Imaging: A Single-institutional Prospective Study

Lughezzani, Giovanni; Maffei, Davide; Saita, Alberto; Paciotti, Marco; Diana, Pietro; Buffi, Nicolò Maria; Colombo, Piergiuseppe; Elefante, Grazia Maria; Hurle, Rodolfo; Lazzeri, Massimo; Guazzoni, Giorgio; Casale, Paolo

doi:10.1016/j.euf.2020.09.013

Cited by 44 publications

(36 citation statements)

References 27 publications

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“…jurology.com), as well as between studies in whom the operator was blinded or unblinded to the mpMRI results at the time of micro-ultrasoundeguided PB Regarding patients with GG !3 PCa, a total of 5 cohort studies with 546 individuals receiving microultrasoundeguided followed by mpMRI-targeted and systematic PB provided relevant data. 22,23,26,31,32 Ultimately, 122 cases of GG !3 PCa were reported by adding the results of the 3 techniques. The microultrasoundeguided PB identified 99, while the mpMRI-targeted PB 79 patients (DR 1.25, 95% CI 0.95e1.64, I 2 [0%, fig.…”

Section: Clinically Significant Pca Detection Ratementioning

confidence: 99%

Micro-Ultrasound–Guided vs Multiparametric Magnetic Resonance Imaging-Targeted Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis

et al. 2021

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Purpose: Micro-ultrasound is a novel high resolution ultrasound technology aiming to improve prostate imaging and, consequently, the diagnostic accuracy of ultrasound-guided prostate biopsy. Micro-ultrasoundeguided prostate biopsy may present comparable detection rates to the standard of care multiparametric magnetic resonance imaging-targeted prostate biopsy for the diagnosis of clinically significant prostate cancer. We aimed to compare the detection rate of micro-ultrasound vs multiparametric magnetic resonance imaging-targeted prostate biopsy for prostate cancer diagnosis. Materials and Methods: We performed a systematic review and meta-analysis of diagnostic accuracy studies comparing micro-ultrasoundeguided prostate biopsy to multiparametric magnetic resonance imaging-targeted prostate biopsy as a reference standard test (PROSPERO ID: CRD42020198326). Records were identified by searching in PubMedÒ, ScopusÒ and Cochrane Library databases, as well as in potential sources of gray literature until November 30th, 2020. Results: We included 18 studies in the qualitative and 13 in the quantitative synthesis. In the quantitative synthesis, 1,125 participants received micro-ultrasoundeguided followed by multiparametric magnetic resonance imaging-targeted and systematic prostate biopsy. Micro-ultrasound and multiparametric magnetic resonance imaging-targeted prostate biopsies displayed similar detection rates across all prostate cancer grades. The pooled detection ratio for International Society of Urological Pathology Grade Group !2 prostate cancer was 1.05 (95% CI 0.93e1.19, I 2 [0%), 1.25 (95% CI 0.95e1.64, I 2 [0%) for Grade Group !3 and 0.94 (95% CI 0.73e1.22, I 2 [0%) for clinically insignificant (Grade Group 1) prostate cancer. The overall detection ratio for prostate cancer was 0.99 (95% CI 0.89e1.11, I 2 [0%). Conclusions: Micro-ultrasoundeguided prostate biopsy provides comparable detection rates for prostate cancer diagnosis with the multiparametric magnetic resonance imaging-guided prostate biopsy. Therefore, it could be considered as an attractive alternative to multiparametric magnetic resonance imaging-targeted prostate biopsy. Nevertheless, high quality randomized trials are warranted to corroborate our findings.

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Section: Clinically Significant Pca Detection Ratementioning

confidence: 99%

Micro-Ultrasound–Guided vs Multiparametric Magnetic Resonance Imaging-Targeted Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis

et al. 2021

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“…Compared to conventional US, real-time micro-US resulted in an increased detection rate of approximately 12% in an early experience at the Cleveland Clinic [79]. In a prospective study of 320 patients, similar detection rates for clinically significant PCa were found between micro-US and mpMRI [80]. More recently, in a multicentre registry of 1,040 B2B: Prostate Cancer Summary patients, the diagnostic performance of micro-US demonstrated comparable or higher sensitivity for clinically significant PCa compared to mpMRI [81].…”

Section: B2b: Prostate Cancer Summarymentioning

confidence: 78%

B2B: Prostate Cancer

Loeb¹,

Black²,

Wyatt³

et al. 2021

Société Internationale D’Urologie Journal

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“…The strength of our study was able to establish the definite link between mpMRI omission and the rate of CSPCa delayed. Some studies showed that a high-resolution micro-ultrasound had a comparable or higher sensitivity for the detection of CSPCa compared to mpMRI ( 26 , 27 ), and was an independent parameter to predict the results of biopsy ( 28 ). In the further study, we will evaluate more convenient, low-cost, clinical parameters as predictors for the results of mpMRI, and to strengthen our multivariate model.…”

Section: Discussionmentioning

confidence: 99%

“…Second, the PV used to calculate PSAD and build a multivariate model was estimated by mpMRI in our study. However, a study showed that PV could be reliably measured by TRUS ( 24 ), and a low-cost micro-ultrasound had a high sensitivity for the detection CSPCa ( 26 , 27 ). Third, our model only included clinical parameters such as age, PSA test, and volume.…”

Section: Discussionmentioning

confidence: 99%

Developing Strategy to Predict the Results of Prostate Multiparametric Magnetic Resonance Imaging and Reduce Unnecessary Multiparametric Magnetic Resonance Imaging Scan

Liu

Dong

et al. 2021

Front. Oncol.

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PurposeThe clinical utility of multiparametric magnetic resonance imaging (mpMRI) for the detection and localization of prostate cancer (PCa) has been evaluated and validated. However, the implementation of mpMRI into the clinical practice remains some burden of cost and availability for patients and society. We aimed to predict the results of prostate mpMRI using the clinical parameters and multivariable model to reduce unnecessary mpMRI scans.MethodsWe retrospectively identified 784 men who underwent mpMRI scans and subsequent prostate biopsy between 2016 and 2020 according to the inclusion criterion. The cohort was split into a training cohort of 548 (70%) patients and a validation cohort of 236 (30%) patients. Clinical parameters including age, prostate-specific antigen (PSA) derivates, and prostate volume (PV) were assessed as the predictors of mpMRI results. The mpMRI results were divided into groups according to the reports: “negative”, “equivocal”, and “suspicious” for the presence of PCa.ResultsUnivariate analysis showed that the total PSA (tPSA), free PSA (fPSA), PV, and PSA density (PSAD) were significant predictors for suspicious mpMRI (P < 0.05). The PSAD (AUC = 0.77) and tPSA (AUC = 0.74) outperformed fPSA (AUC = 0.68) and PV (AUC = 0.62) in the prediction of the mpMRI results. The multivariate model (AUC = 0.80) had a similar diagnostic accuracy with PSAD (P = 0.108), while higher than tPSA (P = 0.024) in predicting the mpMRI results. The multivariate model illustrated a better calibration and substantial improvement in the decision curve analysis (DCA) at a threshold above 20%. Using the PSAD with a 0.13 ng/ml2 cut-off could spare the number of mpMRI scans by 20%, keeping a 90% sensitivity in the prediction of suspicious MRI-PCa and missing three (3/73, 4%) clinically significant PCa cases. At the same sensitivity level, the multivariate model with a 32% cut-off could spare the number of mpMRI scans by 27%, missing only one (1/73, 1%) clinically significant PCa case.ConclusionOur multivariate model could reduce the number of unnecessary mpMRI scans without comprising the diagnostic ability of clinically significant PCa. Further prospective validation is required.

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Diagnostic Accuracy of Microultrasound in Patients with a Suspicion of Prostate Cancer at Magnetic Resonance Imaging: A Single-institutional Prospective Study

Cited by 44 publications

References 27 publications

Micro-Ultrasound–Guided vs Multiparametric Magnetic Resonance Imaging-Targeted Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis

Micro-Ultrasound–Guided vs Multiparametric Magnetic Resonance Imaging-Targeted Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis

B2B: Prostate Cancer

Developing Strategy to Predict the Results of Prostate Multiparametric Magnetic Resonance Imaging and Reduce Unnecessary Multiparametric Magnetic Resonance Imaging Scan

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