Multiparametric ultrasound of prostate: role in prostate cancer diagnosis

Abstract

Recent advances in ultrasonography (US) technology established modalities, such as Doppler-US, HistoScanning, contrast-enhanced ultrasonography (CEUS), elastography, and micro-ultrasound. The early results of these US modalities have been promising, although there are limitations including the need for specialized equipment, inconsistent results, lack of standardizations, and external validation. In this review, we identified studies evaluating multiparametric ultrasonography (mpUS), the combination of multiple US modalities, for prostate cancer (PCa) diagnosis. In the past 5 years, a growing number of studies have shown that use of mpUS resulted in high PCa and clinically significant prostate cancer (CSPCa) detection performance using radical prostatectomy histology as the reference standard. Recent studies have demonstrated the role mpUS in improving detection of CSPCa and guidance for prostate biopsy and therapy. Furthermore, some aspects including lower costs, real-time imaging, applicability for some patients who have contraindication for magnetic resonance imaging (MRI) and availability in the office setting are clear advantages of mpUS. Interobserver agreement of mpUS was overall low; however, this limitation can be improved using standardized and objective evaluation systems such as the machine learning model. Whether mpUS outperforms MRI is unclear. Multicenter randomized controlled trials directly comparing mpUS and multiparametric MRI are warranted.

Advances in radiology and pathology of prostate cancer: a review for the pathologist

“…The ideal approach to the diagnosis of PCa should be to detect significant disease by performing a limited number of targeted biopsy cores and improving the accuracy of standard TRUS by mpUS; clinical studies have shown that mpUS increases sensitivity by 13-59% in detecting PCa 19 , 20 . In the last years, TRUS has been enriched by the introduction of tridimensional and computerized images ( Fig.…”

Identification of impactful imaging biomarker: Clinical applications for breast and prostate carcinoma

“…Der Binnenkontrast zur Detektion von Tumorgewebe ist jedoch nicht ausreichend [38]. Verschiedene neuere Techniken wie der Super-Resolution Ultraschall, ultraschnelle Doppler-sonographische Verfahren, die Ultraschall-Elastographie sowie die KM-verstärkte Sonographie (CEUS) und das Histoscanning haben den Begriff des multiparametrischen Ultraschalls (mpUS) geprägt und die Sensitivität angehoben [39]. Eine randomsierte, kontrollierte Studie mit 306 Patienten konnte jedoch eine Überlegenheit der mpMRT zeigen [40].…”

“…However, internal contrast is not sufficient for detecting tumor tissue [38]. Several recent techniques such as super-resolution ultrasound, ultrafast Doppler sonographic techniques, ultrasound elastography, KM-enhanced sonography (CEUS) and histoscanning have coined the term multiparametric ultrasound (mpUS) and raised the sensitivity [39]. However, a randomized controlled trial of 306 patients demonstrated superiority of mpMRI [40].…”

Contemporary Review of Multimodality Imaging of the Prostate Gland

“…Two relatively recent studies compared a multiparametric TRUS approach utilizing grayscale imaging, color Doppler imaging, shear wave elastography, and contrast-enhanced ultrasound to mpMRI and found that the two approaches had comparable detection rates of localized prostate cancer [23,24]. However, additional studies and meta-analyses have not found that this approach outperforms MRI in most cases, and more research is needed with standardized protocols to validate the results [25].…”