Biopsies guided by means of prime answer ultrasound are as efficient as the ones the use of MRI in diagnosing prostate most cancers, a global medical trial has proven.
The era, known as micro-ultrasound, is less expensive and more straightforward to make use of than MRI. It might considerably accelerate prognosis, scale back the will for a couple of health center visits and unlock MRI for different makes use of, researchers say.
The result of the OPTIMUM trial are introduced as of late [Sunday 23 March 2025] on the Eu Affiliation of Urology Congress in Madrid and printed in JAMA.
OPTIMUM is the primary randomized trial to match micro-ultrasound (microUS) guided biopsy with MRI-guided biopsy for prostate most cancers. It comes to 677 males who underwent biopsy at 19 hospitals throughout Canada, america and Europe. Of those, part underwent MRI-guided biopsy, a 3rd won microUS-guided biopsy adopted by means of MRI-guided biopsy and the rest won microUS-guided biopsy by myself.
MicroUS used to be in a position to spot prostate most cancers as successfully as MRI-guided biopsy, with very equivalent charges of detection throughout all 3 fingers of the trial. There used to be little distinction even within the team who won each sorts of biopsies, with the microUS detecting the vast majority of vital cancers.
Round one million prostate most cancers biopsies are performed each and every 12 months in Europe, a equivalent quantity in america and round 100,000 in Canada. Nearly all of biopsies are carried out the use of MRI photographs fused onto standard ultrasound, as this permits urologists to focus on possible tumours immediately, resulting in simpler prognosis. MRI-guided biopsy calls for a two-step procedure (the MRI scan, adopted by means of the ultrasound-guided biopsy), requiring a couple of health center visits and specialist radiological experience to interpret the MRI photographs and fuse them onto the ultrasound.
Micro-ultrasound has upper frequency than standard ultrasound, leading to thrice better answer photographs that may seize equivalent element to MRI scans for focused biopsies. Clinicians akin to urologists and oncologists may also be simply educated to make use of the method and interpret the photographs, particularly if they have got revel in in standard ultrasound. MicroUS is less expensive to shop for and run in comparison to MRI, and may allow imaging and biopsy to be performed right through one appointment, even outdoor a health center surroundings.
The result of the OPTIMUM trial can have a equivalent have an effect on to the primary creation of MRI, consistent with lead researcher at the trial, Laurence Klotz, Professor of Surgical procedure on the College of Toronto’s Temerty School of Drugs and the Sunnybrook Chair of Prostate Most cancers Analysis.
“When MRI first emerged and you could image prostate cancer accurately for the first time to do targeted biopsies, that was a gamechanger,” he remembers. “However MRI is not best. It is pricey. It may be difficult to get get entry to to it temporarily. It calls for a large number of revel in to interpret correctly. And it makes use of gadolinium which has some toxicity. Now not all sufferers may have MRI, if they have got substitute hips or pacemakers as an example.
“But we now know that microUS can give as good a diagnostic accuracy as MRI and that is also game changing. It means you can offer a one stop shop, where patients are scanned, then biopsied immediately if required. There’s no toxicity. There are no exclusions. It’s much cheaper and more accessible. And it frees up MRIs for hips and knees and all the other things they’re needed for.”
Professor Jochen Walz, from the Institut Paoli-Calmettes Most cancers Heart, Marseille/France, is a number one knowledgeable within the box of urological imaging and a member of the EAU Medical Congress Place of business.
He mentioned: “It is a smartly carried out and thrilling learn about which provides a vital device to the prognosis of prostate most cancers. The usage of micro-ultrasound is a more uncomplicated and more practical procedure. This additionally makes it more secure, by means of warding off the prospective mistakes that may creep in right through the switch of MRI to ultrasound for a fusion biopsy.
“It does require coaching to identify the patterns and interpret micro-ultrasound photographs as it should be. However as soon as that is been mastered, then it would allow prostate most cancers prognosis and biopsy to occur on the similar appointment. It might additionally make focused biopsies extra to be had in much less evolved healthcare programs the place MRI is an excessively treasured useful resource.
“The ease and cost of micro-ultrasound means it could be an important tool for screening programmes as well, but further research would be needed to understand its potential role in that setting.”
The trial used to be subsidized by means of Canadian corporate Precise Imaging, which has evolved the microUS era.
Supply:
Eu Affiliation of Urology
Magazine reference:
Kinnaird, A., et al. (2025). Microultrasonography-Guided vs MRI-Guided Biopsy for Prostate Most cancers Analysis. JAMA. doi.org/10.1001/jama.2025.3579.
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Publish date : 2025-03-24 11:44:00
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