You have accessJournal of UrologyProstate Cancer: Staging (MP11)1 Sep 2021MP11-01 HIGH-RESOLUTION MICRO-ULTRASOUND FOR LOCAL STAGING OF PROSTATE CANCER: A PROSPECTIVE SINGLE-CENTER EXPERIENCE Vittorio Fasulo, Rozzano, Federica Regis, Marco Paciotti, Francesco Persico, Davide Maffei, Alessandro Uleri, Alberto Saita, Rodolfo Hurle, Massimo Lazzeri, Paolo Casale, Giorgio Guazzoni, Nicolò Buffi, and Giovanni Lughezzani Vittorio FasuloVittorio Fasulo More articles by this author , Rozzano Rozzano More articles by this author , Federica RegisFederica Regis More articles by this author , Marco PaciottiMarco Paciotti More articles by this author , Francesco PersicoFrancesco Persico More articles by this author , Davide MaffeiDavide Maffei More articles by this author , Alessandro UleriAlessandro Uleri 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 , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Nicolò BuffiNicolò Buffi More articles by this author , and Giovanni LughezzaniGiovanni Lughezzani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001984.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recently, micro-ultrasound (microUS) has been proposed as an alternative to multiparametric magnetic resonance imaging for the diagnosis of clinically significant Prostate Cancer (PCa), but its role in the local staging of PCa has not been determined yet. Our aim was to evaluate the accuracy of microUS in predicting extraprostatic extension (EPE) of PCa prior to surgery. METHODS: This is a single-institutional prospective cohort study. Patients with biopsy-proven PCa scheduled for robot-assisted radical prostatectomy (RARP) were recruited. Patients with PSA>20ng/mL and a prostate volume>100 mL, were excluded. All patients underwent microUS before RARP. The following ultrasound features were evaluated as predictors of non-organ-confined disease: curvilinear contact length(CCL), capsular bulging, visible breach of the prostate capsule(visible extracapsular extension; ECE), presence of hypoechoic halo or ring, and obliteration of the vesicle-prostatic angle. The ability of each feature to predict EPE was determined. Multivariable logistic regression models (LRMs) were fitted to test the predictors of EPE, and their accuracy estimated with the area under the ROC-curve (AUC) analysis. The diagnostic performance of the most accurate predictor was tested. RESULTS: Overall, 140 patients were recruited. Besides CCL, all predictors were associated with non-organ-confined disease (p<0.001). Final pathology showed that 79 (56.4%) and 61(43.3%) had respectively a pT2 and a pT3 or greater disease. Rate of non-organ-confined disease increased from 44% in those individuals with only 1 predictor (OR 7.71, 95% CI 1.63-13.60), to 92.3% in those where 4 predictors were simultaneously observed (OR 72.00, 95% CI 8.31-623.44). At MLRM, the most significant risk factors for EPE were visible ECE (OR 9.66; 95%CI 3.64–25.66; p<0.0001), positive digital rectal examination (OR 3.43; 95%CI 1.33–8.89; p=0.011) and capsular bulge (OR 3.28, 95%CI 1.26–8.54, p=0.015). Presence of ECE at microUS predicted EPE with a sensitivity of 72.1% and a specificity of 88%, a negative predictive value of 80.5% and positive predictive value of 83.0%. CONCLUSIONS: Our findings suggest that microUS may represent an accurate tool for the evaluation of non-organ confined PCa. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e177-e177 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vittorio Fasulo More articles by this author Rozzano More articles by this author Federica Regis More articles by this author Marco Paciotti More articles by this author Francesco Persico More articles by this author Davide Maffei More articles by this author Alessandro Uleri 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 Giorgio Guazzoni More articles by this author Nicolò Buffi More articles by this author Giovanni Lughezzani More articles by this author Expand All Advertisement Loading ...