Diagnostic performance of 29-MHz micro-ultrasound using cognitive fusion with multiparametric MRI for the detection of clinically significant prostate cancer: a single-center retrospective study.

Abstract

Introduction: The aim of this study was to evaluate the diagnostic performance of 29-MHZ micro-ultrasound with cognitive fusion based on multiparametric MRI for the detection of clinically significant prostate cancer.

Materials and methods: A single-center retrospective study included 185 patients who underwent targeted prostate biopsies between January 2022 and December 2023. Biopsies were all performed with a 29-MHz high-resolution micro-ultrasound system, combined with cognitive fusion based on prior prostate MRI. Primary endpoint was the detection rate of clinically significant prostate cancer defined as ISUP grade ≥ 2. MRI-ultrasound discordances were also analysed, as well as the diagnostic performance of the PRI-MUS score.

Results: The overall prostate cancer detection rate was 68%, with a clinically significant cancer detection rate of 47%. MRI-ultrasound concordance was observed in 152 patients, with a 50% detection rate for ISUP grade ≥ 2 cancers. Among ultrasound targets not identified on MRI, three clinically significant cancers were detected. The PRI-MUS score showed a sensitivity of 75%, a specificity of 36%, and an AUC of 0.66.

Conclusion: 29-MHz micro-ultrasound combined with cognitive fusion based on multiparametric MRI demonstrated good diagnostic performance for the detection of clinically significant prostate cancer. Micro-ultrasound may represent a complementary imaging modality to MRI, particularly in cases of MRI-ultrasound discordance.