Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI
Background/Objectives: Multiparametric MRI (mpMRI) is widely established as the standard imaging modality for detecting clinically significant prostate cancer (csPCa), yet it can be limited by cost, accessibility, and the need for specialized radiologist interpretation. Micro-ultrasound (micro-US) h...
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MDPI AG
2025-07-01
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| author | Julien DuBois Shayan Smani Aleksandra Golos Carlos Rivera Lopez Soum D. Lokeshwar |
| author_facet | Julien DuBois Shayan Smani Aleksandra Golos Carlos Rivera Lopez Soum D. Lokeshwar |
| author_sort | Julien DuBois |
| collection | DOAJ |
| description | Background/Objectives: Multiparametric MRI (mpMRI) is widely established as the standard imaging modality for detecting clinically significant prostate cancer (csPCa), yet it can be limited by cost, accessibility, and the need for specialized radiologist interpretation. Micro-ultrasound (micro-US) has recently emerged as a more accessible alternative imaging modality. This review evaluates whether the evidence base for micro-US meets thresholds comparable to those that led to MRI’s guideline adoption, synthesizes diagnostic performance data compared to mpMRI, and outlines future research priorities to define its clinical role. Methods: A targeted literature review of PubMed, Embase, and the Cochrane Library was conducted for studies published between 2014 and May 2025 evaluating micro-US in csPCa detection. Search terms included “micro-ultrasound,” “ExactVu,” “PRI-MUS,” and related terminology. Study relevance was assessed independently by the authors. Extracted data included csPCa detection rates, modality concordance, and diagnostic accuracy, and were synthesized and, rarely, restructured to facilitate study comparisons. Results: Micro-US consistently demonstrated non-inferiority to mpMRI for csPCa detection across retrospective studies, prospective cohorts, and meta-analyses. Several studies reported discordant csPCa lesions detected by only one modality, highlighting potential complementarity. The recently published OPTIMUM randomized controlled trial offers the strongest individual-trial evidence to date in support of micro-US non-inferiority. Conclusions: Micro-US shows potential as an alternative or adjunct to mpMRI for csPCa detection. However, additional robust multicenter studies are needed to achieve the evidentiary strength that led mpMRI to distinguish itself in clinical guidelines. |
| format | Article |
| id | doaj-art-b8c43f07a8114797b3fa2dceb033beec |
| institution | DOAJ |
| issn | 2379-1381 2379-139X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
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| series | Tomography |
| spelling | doaj-art-b8c43f07a8114797b3fa2dceb033beec2025-08-20T02:47:21ZengMDPI AGTomography2379-13812379-139X2025-07-011178010.3390/tomography11070080Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRIJulien DuBois0Shayan Smani1Aleksandra Golos2Carlos Rivera Lopez3Soum D. Lokeshwar4Department of Urology, Yale School of Medicine, New Haven, CT 06510, USADepartment of Urology, Yale School of Medicine, New Haven, CT 06510, USADepartment of Urology, Yale School of Medicine, New Haven, CT 06510, USAThe James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USAThe James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USABackground/Objectives: Multiparametric MRI (mpMRI) is widely established as the standard imaging modality for detecting clinically significant prostate cancer (csPCa), yet it can be limited by cost, accessibility, and the need for specialized radiologist interpretation. Micro-ultrasound (micro-US) has recently emerged as a more accessible alternative imaging modality. This review evaluates whether the evidence base for micro-US meets thresholds comparable to those that led to MRI’s guideline adoption, synthesizes diagnostic performance data compared to mpMRI, and outlines future research priorities to define its clinical role. Methods: A targeted literature review of PubMed, Embase, and the Cochrane Library was conducted for studies published between 2014 and May 2025 evaluating micro-US in csPCa detection. Search terms included “micro-ultrasound,” “ExactVu,” “PRI-MUS,” and related terminology. Study relevance was assessed independently by the authors. Extracted data included csPCa detection rates, modality concordance, and diagnostic accuracy, and were synthesized and, rarely, restructured to facilitate study comparisons. Results: Micro-US consistently demonstrated non-inferiority to mpMRI for csPCa detection across retrospective studies, prospective cohorts, and meta-analyses. Several studies reported discordant csPCa lesions detected by only one modality, highlighting potential complementarity. The recently published OPTIMUM randomized controlled trial offers the strongest individual-trial evidence to date in support of micro-US non-inferiority. Conclusions: Micro-US shows potential as an alternative or adjunct to mpMRI for csPCa detection. However, additional robust multicenter studies are needed to achieve the evidentiary strength that led mpMRI to distinguish itself in clinical guidelines.https://www.mdpi.com/2379-139X/11/7/80micro-ultrasoundExact-Vuprostate cancerprostate biopsyPRI-MUS |
| spellingShingle | Julien DuBois Shayan Smani Aleksandra Golos Carlos Rivera Lopez Soum D. Lokeshwar Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI Tomography micro-ultrasound Exact-Vu prostate cancer prostate biopsy PRI-MUS |
| title | Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI |
| title_full | Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI |
| title_fullStr | Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI |
| title_full_unstemmed | Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI |
| title_short | Micro-Ultrasound in the Detection of Clinically Significant Prostate Cancer: A Comprehensive Review and Comparison with Multiparametric MRI |
| title_sort | micro ultrasound in the detection of clinically significant prostate cancer a comprehensive review and comparison with multiparametric mri |
| topic | micro-ultrasound Exact-Vu prostate cancer prostate biopsy PRI-MUS |
| url | https://www.mdpi.com/2379-139X/11/7/80 |
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