Evaluating the Role of Ultrasound in Prostate Cancer trial – phase 1: Early experience of micro-ultrasound in the United Kingdom

Parker, Pamela; Twiddy, Maureen; Rigby, Alan; Whybrow, Paul; Simms, Matthew

Abstract

Purpose: The purpose of this study was to evaluate if the use of micro-ultrasound can detect clinically significant prostate pathology when compared to histology obtained during a transperineal prostate biopsy. Methods: Patients suspected of having prostate cancer, who had a pre-biopsy magnetic resonance imaging and could tolerate a transrectal examination, were prospectively recruited. All patients had a micro-ultrasound scan prior to their biopsy. The findings of magnetic resonance imaging, micro-ultrasound and histology were risk stratified in accordance with local pathways. Comparison of assigned risk scores was made using histology as the reference standard. Results: Data from 101 patients were evaluated. Histology showed that clinically significant prostate cancer was detected in 48.5% (n = 49/101) of patients. Moderate inter-rater agreement was found in both magnetic resonance imaging and micro-ultrasound with К of 0.31 in both modalities. High-risk findings were identified in 81% (n = 82/101) patients at magnetic resonance imaging and in 66% (n = 67/101) patients at micro-ultrasound. Sensitivity and specificity of magnetic resonance imaging were found to be 87% and 34.6% and for micro-ultrasound 73.3% and 53.8%, respectively. Conclusion: A limitation of this study was that the biopsy was not performed with micro-ultrasound which may have resulted in unidentified cancers and lowered the apparent accuracy of the technique. However, we conclude that while micro-ultrasound was diagnostic, magnetic resonance imaging demonstrated higher sensitivity in our local population and remains the pre-biopsy imaging modality of choice. However, the higher specificity of micro-ultrasound identified does indicate that it may be of value when magnetic resonance imaging is contraindicated. The role of micro-ultrasound, within an active surveillance pathway for prostate cancer, warrants further investigation.

Citation

Parker, P., Twiddy, M., Rigby, A., Whybrow, P., & Simms, M. (2024). Evaluating the Role of Ultrasound in Prostate Cancer trial – phase 1: Early experience of micro-ultrasound in the United Kingdom. Ultrasound, https://doi.org/10.1177/1742271X231226302

• Journal Article Type: Article
• Acceptance Date: Dec 28, 2023
• Online Publication Date: Feb 14, 2024
• Publication Date: Jan 1, 2024
• Deposit Date: Jan 2, 2024
• Publicly Available Date: Feb 16, 2024
• Journal: Ultrasound
• Print ISSN: 1742-271X
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/1742271X231226302
• Keywords: Sonographer; MicroUS; Diagnosis; Prostate biopsy; Active surveillance
• Public URL: https://hull-repository.worktribe.com/output/4499614