Comparing the Diagnostic Performance of Micro- Ultrasound-Guided Biopsy Versus Multiparametric Magnetic Resonance Imaging-Targeted Biopsy in the Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-Analysis
Abstract
Background Micro-ultrasound is a novel, high-resolution imaging modality that aims to improve the accuracy
of prostate cancer diagnosis compared with TRUS-guided biopsy. While traditional ultrasound systems operate at
8 to 12 MHz, micro-ultrasound operates at 29 MHz, allowing enhanced recognition of microstructures with 300%
higher resolution. Micro-ultrasound can potentially identify and target in real-time suspicious lesions, improving
sensitivity and the negative predictive value for clinically significant prostate cancer. It may be a low-cost alternative to
multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer.
Methods A systematic review and meta-analysis was performed comparing the diagnostic performance of microultrasound-
guided prostate biopsies with mpMRI-targeted prostate biopsies in the detection of clinically significant
prostate cancer. PubMed, EMBASE, SCOPUS, and Cochrane CENTRAL databases were searched to identify relevant
studies published up to July 2022.
Results A total of 15 studies were included for the systematic review, with 12 of those studies being included for
the meta-analysis. The pooled sensitivity and specificity for micro-ultrasound-guided biopsies detecting clinically
significant prostate cancer were 89% (95% CI 83 to 93) and 31% (95% CI 23 to 40) respectively (I2 = 0%). In comparison,
the pooled sensitivity and specificity for mpMRI-targeted biopsies detecting clinically significant prostate cancer
were 86% (95% CI 73 to 93) and 32% (95% CI 18 to 50) respectively (I2 = 16%). There was no statistically significant
difference in the sensitivity or specificity between micro-ultrasound and mpMRI. Subgroup analysis found no
difference in MRI subgroups based on blinding (P = 0.383).
Conclusion Micro-ultrasound-guided biopsies are comparable to mpMRI targeted biopsies with no difference in
the detection of clinically significant prostate cancer between the 2 modalities. Large, multicentre, prospective studies
are required to further substantiate the use of micro-ultrasound as an alternative to or in conjunction with mpMRI
in the detection of prostate cancer.
The Société International d'Urologie (SIU), which owns and publishes the Société International d'Urologie Journal (SIUJ), does not require authors of papers published in the journal to transfer copyright. Instead, we ask authors to grant an exclusive licence that allows us to publish the article in SIUJ (and any derivative or related products or publications) and that allows us to sub-license such rights and exploit all subsidiary rights.
Authors retain the right to use their own articles for their own non-commercial purposes without seeking explicit permission from SIU.
The SIUJ publication licence expressly defines “non-commercial” as “not primarily intended for or directed towards commercial advantage or monetary compensation.” Although no activity is completely disconnected from commercial activity, the following are generally considered to be non-commercial uses:
- Reproduction of a reasonable number (no more than 100) of print copies of the published paper for personal use (e.g., sharing with colleagues, including in grant applications).
- Posting a copy of the published version of the paper on the author’s own or their institution’s website. The article must be accompanied by this statement: ‘This article has been published in the SIUJ: [full citation; link]’.
- Inclusion of the paper in a course pack, with a maximum of 100 copies to be used in the author’s institution. The copies must include the following acknowledgement: ‘This article has been published in the SIUJ: [full citation; link].’
As the distinction between commercial and non-commercial is not always clear, authors are strongly advised to seek permission from SIU for any use that may be considered to have a commercial aspect.
We ask the corresponding author to read the terms of the licence and then to grant this exclusive licence on behalf of all authors by indicating agreement to the following statement:
The corresponding author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence on a worldwide basis to the SIU and its licensees to permit this article (if accepted) to be published in the SIUJ and any other SIU products and publications and to exploit all subsidiary rights, as set out in our licence agreement.
Review and Decision
Most submissions will be reviewed by a senior editor within 2 weeks. Many manuscripts will be rejected at this point for a variety of reasons, including subject matter outside the scope of the SIUJ, flawed design, discredited or outdated methodology, poor organization or presentation, failure to conform to ethical requirements, and apparent plagiarism.The remaining manuscripts will be sent for peer review. The SIUJ uses a single-blind process: reviewers know the identity of the authors, but the authors are not told who has reviewed their manuscript, and SIUJ ensures that potentially identifying information is removed from comments sent to them. Reviewers are asked to make their recommendations within 10 days, after which a senior/specialist editor will consider their comments and recommend provisional acceptance dependent on satisfactory revision, acceptance without revision, or rejection. Authors should receive a final decision within 4 to 6 weeks of submission.
