WITHDRAWN: The benefit of adopting Microultrasound in the prostate cancer imaging pathway : A lesion-by-lesion analysis

P Martel; A Rakauskas; J Dagher; S La Rosa; J Y Meuwly; B Roth; M Valerio

doi:10.1016/j.purol.2022.02.005

WITHDRAWN: The benefit of adopting Microultrasound in the prostate cancer imaging pathway : A lesion-by-lesion analysis

Prog Urol. 2022 Mar 12:S1166-7087(22)00066-5. doi: 10.1016/j.purol.2022.02.005. Online ahead of print.

Authors

P Martel¹, A Rakauskas¹, J Dagher², S La Rosa³, J Y Meuwly⁴, B Roth¹, M Valerio⁵

Affiliations

¹ Department of Urology, Lausanne University Hospital, Lausanne, Switzerland.
² Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland.
³ Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland; Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁴ Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland.
⁵ Department of Urology, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: massimo.valerio@chuv.ch.

PMID: 35292179
DOI: 10.1016/j.purol.2022.02.005

Abstract

Introduction: Microultrasound (MicroUS) is a novel imaging modality relying on a high-frequency transducer which confers a three-fold improvement in spatial resolution as compared with conventional transrectal ultrasound. We evaluated the diagnostic value of MRI-MicroUS fusion biopsy and determined the additional benefit of employing MicroUS.

Methods: Retrospective analysis of consecutive treatment-naïve men undergoing MRI-MicroUS fusion biopsy between May 2018 and March 2019. Pre-biopsy MRI was systematically reviewed in a dedicated meeting where suspicious lesions PIRADS≥3 were registered and uploaded in the ExactVu MicroUS device. MRI and MicroUS lesions were individually marked in a PIRADS v2 scheme. The biopsy protocol included MRI-MicroUS fusion and MicroUS targeted biopsies; systematic biopsies were performed at clinician's discretion. The diagnostic value was evaluated in terms of detection rate of clinically significant prostate cancer, defined as Gleason pattern≥4 at histology.

Results: In all, 148 patients with a median age of 69 years (IQR 63-74) and median PSA density of 0.16ng/ml/cc (0.10-0.23) were included. Clinically significant cancer was detected in 42.5% (63/148) patients. MRI detected 89 lesions in the peripheral zone; 73% (65/89) were visible on MicroUS. Clinically significant cancer was detected in 46.1% (30/65) MRI and MicroUS visible lesions, and in 4.2% (1/24) lesions only visible on mpMRI. MicroUS additionally identified 35 suspicious lesions non-visible on MRI of which clinically significant cancer was present in 25.7% (9/35).

Conclusion: Adding MicroUS to the conventional pathway seems to increase the detection rate of clinically significant disease in unselected men undergoing biopsy.

Keywords: Biopsie de la prostate; Cancer de la prostate; Imagerie par résonance magnétique; Magnetic resonance imaging; Micro-échographie; Microultrasound; Prostate biopsy; Prostate cancer.