Comparing Micro-Ultrasound to mpMRI in Detecting Clinically Significant Prostate Cancer
Abstract
Objectives: To compare the performance of micro-ultrasound (mUS) with multi-parametric magnetic resonance
imaging (mpMRI) in detecting clinically significant prostate cancer.
Materials and Methods: Retrospective data from consecutive patients with any indication for prostate biopsy in
2 academic institutions were included. The operator, blinded to mpMRI, would first scan the prostate and annotate
any mUS lesions. All mUS lesions were biopsied. Any mpMRI lesions that did not correspond to mUS lesion upon
unblinding were additionally biopsied. Grade group (GG) ≥ 2 was considered clinically significant cancer. The Jeffreys
interval method was used to compare performance of mUS with mpMRI with the non-inferiority limit set at −5%.
Results: Imaging and biopsy were performed in 82 patients with 153 lesions. mUS had similar sensitivity to mpMRI
(per-lesion analysis: 78.4% versus 72.5%), but lower specificity, positive predictive value, negative predictive value, and
area under the curve. Micro-ultrasound found GG ≥ 2 in 13% of cases missed by mpMRI, while mpMRI found GG ≥
2 in 11% of cases missed by mUS. The difference 0.020 (95% CI −0.070 to 0.110) was not statistically significant
(P = 0.33).
Conclusion: The sensitivity of mUS in detecting GG ≥ 2 disease was similar to that of mpMRI, but the specificity
was lower. Further evaluation with a larger sample size and experienced operators is warranted.
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