Correlation of Prostate High-Resolution Microultrasound With Multiparametric Magnetic Resonance Imaging - 13/12/24

Doi : 10.1016/j.urology.2024.11.048

Nicholas A. Pickersgill ^a,^b,^⁎ , Muhammad Hassan Alkazemi ^a,^b, Adam Ostergar ^a,^c, Karan Joseph ^a, Joel M. Vetter ^a, Nimrod S. Barashi ^a, Eric H. Kim ^a, Gerald L. Andriole ^a, Arjun Sivaraman ^a,^d
^a Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO
^b Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
^c Department of Urology, Mayo Clinic, Phoenix, AZ
^d Department of Urology, Medical College of Wisconsin, Milwaukee, WI

^⁎Address correspondence to: Nicholas A. Pickersgill, M.D., 425 Main Street Apt 6P, New York, NY 10044.425 Main Street Apt 6PNew YorkNY10044

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 13 December 2024

Résumé

Objective

To assess the correlation between high-resolution microultrasound (microUS) and multiparametric magnetic resonance imaging (MP-MRI) in clinically significant prostate cancer (csPCa) lesion identification.

Methods

We reviewed our prospectively maintained database of 267 consecutive patients who underwent MP-MRI and transperineal microUS-guided biopsy between February 2021 and April 2023. The Prostate Risk Identification using MicroUS (PRI-MUS) protocol was utilized to risk stratify prostate lesions, with PRI-MUS 3-5 defined as positive. MRI lesions were classified according to the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1. Clinicopathologic outcomes were analyzed. Spearman correlation testing was computed to assess the relationship between PRI-MUS and PI-RADS.

Results

A total of 161 patients met inclusion criteria. Mean±standard deviation age was 65.6±1.5years and prostate-specific antigen was 7.6±0.6ng/mL. Ninety-two patients were found to have PIRADS 3-5 lesions. Spearman correlation analysis revealed a moderate positive correlation between PRI-MUS and PI-RADS (r=0.40, P<.001). MicroUS-targeted cores detected higher grade disease than systematic and MRI-targeted cores in 8/161 (5.0%) patients. CsPCa would have been missed in 4/161 (2.5%) patients without microUS-targeted sampling.

Conclusion

MicroUS/PRI-MUS demonstrates moderate positive correlation with MP-MRI/PI-RADS and offers improved csPCa detection compared to MRI-targeted biopsy alone. MicroUS may be useful in conjunction with MP-MRI or as an alternative imaging modality in MRI-ineligible patients.

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