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

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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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