Pickersgill Nicholas A, Alkazemi Muhammad Hassan, Ostergar Adam, Joseph Karan, Vetter Joel M, Barashi Nimrod S, Kim Eric H, Andriole Gerald L, Sivaraman Arjun
Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO; Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO; Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Urology. 2025 Mar;197:33-39. doi: 10.1016/j.urology.2024.11.048. Epub 2024 Nov 28.
To assess the correlation between high-resolution microultrasound (microUS) and multiparametric magnetic resonance imaging (MP-MRI) in clinically significant prostate cancer (csPCa) lesion identification.
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.
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.
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.
评估高分辨率微超声（microUS）与多参数磁共振成像（MP-MRI）在临床显著性前列腺癌（csPCa）病变识别中的相关性。
我们回顾了2021年2月至2023年4月期间267例连续接受MP-MRI和经会阴微超声引导活检患者的前瞻性维护数据库。采用微超声前列腺风险识别（PRI-MUS）方案对前列腺病变进行风险分层，PRI-MUS 3 - 5定义为阳性。MRI病变根据前列腺影像报告和数据系统（PI-RADS）第2.1版进行分类。分析临床病理结果。计算Spearman相关性检验以评估PRI-MUS与PI-RADS之间的关系。
共有161例患者符合纳入标准。平均年龄±标准差为65.6±1.5岁，前列腺特异性抗原为7.6±0.6 ng/mL。92例患者发现有PI-RADS 3 - 5级病变。Spearman相关性分析显示PRI-MUS与PI-RADS之间存在中度正相关（r = 0.40，P <.001）。在161例患者中的8例（5.0%）中，微超声靶向活检样本检测到的疾病分级高于系统活检和MRI靶向活检样本。在4例（2.5%）患者中，若没有微超声靶向采样，csPCa将会被漏诊。
微超声/PRI-MUS与MP-MRI/PI-RADS显示出中度正相关，与单独的MRI靶向活检相比，能提高csPCa的检测率。微超声可与MP-MRI联合使用，或作为不符合MRI检查条件患者的替代成像方式。
