MP55-15 IS MICROULTRASOUND A RELIABLE TOOL FOR PROSTATE CANCER DIAGNOSIS? RESULTS FROM A SINGLE-INSTITUTION COHORT OF OVER 1,000 MEN

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You have accessJournal of UrologyCME1 Apr 2023MP55-15 IS MICROULTRASOUND A RELIABLE TOOL FOR PROSTATE CANCER DIAGNOSIS? RESULTS FROM A SINGLE-INSTITUTION COHORT OF OVER 1,000 MEN Nicola Frego, Fabio De Carne, Paola Arena, Vittorio Fasulo, Davide Maffei, Chiarelli Giuseppe, Edoardo Beatrici, Marco Paciotti, Pier Paolo Avolio, Alberto Saita, Rodolfo Hurle, Massimo Lazzeri, Paolo Casale, Nicolò Maria Buffi, and Giovanni Lughezzani Nicola FregoNicola Frego More articles by this author , Fabio De CarneFabio De Carne More articles by this author , Paola ArenaPaola Arena More articles by this author , Vittorio FasuloVittorio Fasulo More articles by this author , Davide MaffeiDavide Maffei More articles by this author , Chiarelli GiuseppeChiarelli Giuseppe More articles by this author , Edoardo BeatriciEdoardo Beatrici More articles by this author , Marco PaciottiMarco Paciotti More articles by this author , Pier Paolo AvolioPier Paolo Avolio More articles by this author , Alberto SaitaAlberto Saita More articles by this author , Rodolfo HurleRodolfo Hurle More articles by this author , Massimo LazzeriMassimo Lazzeri More articles by this author , Paolo CasalePaolo Casale More articles by this author , Nicolò Maria BuffiNicolò Maria Buffi More articles by this author , and Giovanni LughezzaniGiovanni Lughezzani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003308.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Microultrasound (mUS) is a new imaging modality that has been proposed as a possible alternative to mpMRI for the diagnosis of Prostate Cancer (PCa). We evaluated the diagnostic performance in the detection of PCa and mUS specific predictors of PCa. METHODS: Between September 2017 and November 2021, data from 1,004 consecutive men who underwent mUS at our tertiary center were prospectively collected. Prior to prostate biopsy, all patients performed a mUS evaluation and those with lesions suspicious for PCa underwent transrectal cognitive targeted biopsies (TBx). PRI-MUS grading system was used to assess the risk of PCa, and any lesion with a PRI-MUS ≥ 3 was considered suspicious. All mUS assessment were performed by 2 urologists with years of experience in US. Primary endpoint was to assess the diagnostic performance of mUS in PCa and csPCa detection. The secondary endpoint was to assess the mUS-derived characteristics associated with PCa and csPCa diagnosis. RESULTS: Median age was 66 years (IQR:60-72); median PSA was 7 (IQR:5-10); 283 (28%) had a positive DRE; median prostate volume was 50 cc (IQR:35-70); 257 (25.6%) had familiarity for PCa; 392 (30%) had previous prostate biopsies; 766 (76.3%) patients had positive mUS; 193 (19.2%) had>1 mUS lesion; out of 766 positive mUS, 10.5% were PRI-MUS 3, 45.2% PRI-MUS 4, and 20.5% PRI-MUS 5. MicroUS detected suspicious lesions in 448/527 (85%) PCa patients and in 325/366 (88.8%) csPCa patients. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of PCa were 85%, 32.3%, 58.6% and 65.7%, respectively; and 88.8%, 23.1%, 73.7% and 46% for csPCa. Out of 448 positive mUS, 172 (38.4%) PCa cases were diagnosed with mUS TBx, of which 147 were csPCa. At multivariable regression model with PCa diagnosis as outcome, having a positive mUS was significantly associated with PCa diagnosis (OR:2.01, 95%CIs:1.28-3.16). In the model with csPCa as main outcome, positive mUS was no longer a significant predictor (OR:1.84, 95%CIs:0.83-4.12). PRIMUS 5 lesion was the only mUS factor associated with PCa diagnosis (OR:2.69, 95%CIs:1.05-6.9). Furthermore, we found a significant increase in the trend of PCa detection at mUS by both operators comparing the first quarter (12,5 months) of the study period and the last 3 quarters (ptrend=0.02 for operator 1; ptrend=0.01 for operator 2). CONCLUSIONS: Our results confirmed the role of mUS in the diagnostic pathway of PCa. Further randomized studies are needed to confirm the potential role of mUS in the diagnostic pathway of PCa. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e769 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicola Frego More articles by this author Fabio De Carne More articles by this author Paola Arena More articles by this author Vittorio Fasulo More articles by this author Davide Maffei More articles by this author Chiarelli Giuseppe More articles by this author Edoardo Beatrici More articles by this author Marco Paciotti More articles by this author Pier Paolo Avolio More articles by this author Alberto Saita More articles by this author Rodolfo Hurle More articles by this author Massimo Lazzeri More articles by this author Paolo Casale More articles by this author Nicolò Maria Buffi More articles by this author Giovanni Lughezzani More articles by this author Expand All Advertisement PDF downloadLoading ...