The benefit of adopting Microultrasound in the prostate cancer imaging pathway: A lesion-by-lesion analysis: Biopsies prostatiques guidée par micro-échographie, quel bénéfice ? Une analyse lésion par lésion.

Autor:	Martel P; Department of Urology, Lausanne University Hospital, Lausanne, Switzerland., Rakauskas A; Department of Urology, Lausanne University Hospital, Lausanne, Switzerland., Dagher J; Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland., La Rosa S; Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland; Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy., Meuwly JY; Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland., Roth B; Department of Urology, Lausanne University Hospital, Lausanne, Switzerland., Valerio M; Department of Urology, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: massimo.valerio@chuv.ch.
Jazyk:	angličtina
Zdroj:	Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie [Prog Urol] 2022 Jun; Vol. 32 (6S1), pp. 6S26-6S32.
DOI:	10.1016/S1166-7087(22)00172-5
Abstrakt:	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 0.16 ng/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. © 2022 Elsevier Masson SAS. All rights reserved. Competing Interests: Disclosure of interest All the authors have no competing interest to declare regarding this article. (Copyright © 2022 Elsevier Masson SAS. Tous droits réservés.)
Databáze:	MEDLINE
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