Evolution of Targeted Prostate Biopsy by Adding Micro-Ultrasound to the Magnetic Resonance Imaging Pathway

Wiemer, Laura; Hollenbach, Markus; Heckmann, Robin; Kittner, Beatrice; Plage, Henning; Reimann, Maximillian; Asbach, Patrick; Friedersdorff, Frank; Schlomm, Thorsten; Hofbauer, Sebastian L.; Cash, Hannes

doi:10.1016/j.euf.2020.06.022

Cited by 33 publications

(34 citation statements)

References 29 publications

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“…This suggests that micro-US may add significant information to current MRI approaches [84]. Similarly, in another study, the combination of micro-US and mpMRI was revealed as the best approach for the detection of clinically significant PCa [85].…”

Section: B2b: Prostate Cancer Summarymentioning

confidence: 88%

B2B: Prostate Cancer

Loeb¹,

Black²,

Wyatt³

et al. 2021

Proceedings From the SIU B2B Uro-Oncology: GU Cancers Triad Virtual Meeting May 21–22, 2021

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Section: B2b: Prostate Cancer Summarymentioning

confidence: 88%

B2B: Prostate Cancer

Loeb¹,

Black²,

Wyatt³

et al. 2021

Proceedings From the SIU B2B Uro-Oncology: GU Cancers Triad Virtual Meeting May 21–22, 2021

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“…Here, the overdetection of additional 9.8% ISUP 1 by systematic biopsy is frequently considered tolerable [37]. Wiemer et al [38] recently reported comparable overall detection rates for PC through the combination of MRI-and micro-ultrasound-targeted biopsy as in the combination of MRI-targeted and nontargeted biopsy (66 vs. 65%) but a lower detection rate for PC graded ISUP 1 for the combined targeted approach (20 vs. 28%).…”

Section: Discussionmentioning

confidence: 99%

Robotic Transrectal Computed Tomographic Ultrasound with Artificial Neural Network Analysis: First Validation and Comparison with MRI-Guided Biopsies and Radical Prostatectomy

et al. 2021

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Introduction: There is still a lack of availability of high-quality multiparametric magnetic resonance imaging (mpMRI) interpreted by experienced uro-radiologists to rule out clinically significant PC (csPC). Consequently, we developed a new imaging method based on computed tomographic ultrasound (US) supported by artificial neural network analysis (ANNA). Methods: Two hundred and two consecutive patients with visible mpMRI lesions were scanned and recorded by robotic CT-US during mpMRI-TRUS biopsy. Only significant index lesions (ISUP ≥2) verified by whole-mount pathology were retrospectively analyzed. Their visibility was reevaluated by 2 blinded investigators by grayscale US and ANNA. Results: In the cohort, csPC was detected in 105 cases (52%) by mpMRI-TRUS biopsy. Whole-mount histology was available in 44 cases (36%). In this subgroup, mean PSA level was 8.6 ng/mL, mean prostate volume was 33 cm3, and mean tumor volume was 0.5 cm3. Median PI-RADS and ISUP of index lesions were 4 and 3, respectively. Index lesions were visible in grayscale US and ANNA in 25 cases (57%) and 30 cases (68%), respectively. Combining CT-US-ANNA, we detected index lesions in 35 patients (80%). Conclusions: The first results of multiparametric CT-US-ANNA imaging showed promising detection rates in patients with csPC. US imaging with ANNA has the potential to complement PC diagnosis.

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“…Wiemer et al. [ 34 ] reported on a cohort of 159 patients with mostly PI-RADS ≥3. The urologists were blinded to the MRI until the conclusion of the MUSGB.…”

Section: Methodsmentioning

confidence: 99%

“…The group did not report separate detection rates, but MUS sensitivity for csPC was comparable with the other groups on a patient level (95%). The positive predictive value on a lesion level of MRI and MUS was 30% and 41% ( p = 0.02), respectively [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

Micro-Ultrasound: a way to bring imaging for prostate cancer back to urology

Harland

Stenzl

2021

Prostate International

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Only a decade ago, there were insufficient imaging options for the detection and local staging of prostate cancer. However, the introduction of multiparametric magnetic resonance imaging (mpMRI) has advanced a much-needed tool for this scope of application. The possibilities and limitations of mpMRI have been well studied. Imaging must be acquired and evaluated using a standardized protocol (the latest version of Prostate Imaging–Reporting and Data System). Sensitivity has been shown to increase with higher grades and larger tumors, and while the detection rate on a per patient basis is relatively high, the per-lesion detection rate is far inferior. Various specialists have attempted to elevate the use of transrectal ultrasound, a tool frequently used by all urologists. Encouragement for this idea comes from a recently introduced system of high frequency transrectal ultrasound. The level of evidence supporting its use in the detection and staging of prostate cancer is not comparable with mpMRI yet, but initial prospective studies indicate good potential. The sensitivity of micro-ultrasound and mpMRI for clinically significant prostate cancer ranges from 94% to 100% and from 88% to 90%, respectively. Further areas of application, such as local staging for prostate and bladder cancer, are currently being evaluated. In summary, microultrasound presents a promising technology for further improving urological imaging and allows for the possibility of returning prostate cancer imaging to urologists. This review will summarize the current scientific basis for the use of micro-ultrasound in the detection of prostate cancer.

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Evolution of Targeted Prostate Biopsy by Adding Micro-Ultrasound to the Magnetic Resonance Imaging Pathway

Cited by 33 publications

References 29 publications

B2B: Prostate Cancer

B2B: Prostate Cancer

Robotic Transrectal Computed Tomographic Ultrasound with Artificial Neural Network Analysis: First Validation and Comparison with MRI-Guided Biopsies and Radical Prostatectomy

Micro-Ultrasound: a way to bring imaging for prostate cancer back to urology

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