New Delhi, March 23 An international clinical trial showed on Sunday that biopsies guided by high resolution ultrasound are as effective as those using MRI in diagnosing prostate cancer.
The technology, called micro-ultrasound, is cheaper and easier to use than MRI.
“It could significantly speed up diagnosis, reduce the need for multiple hospital visits and free up MRI for other uses,” said researchers. The results of the trial were presented at the European Association of Urology Congress in Madrid and published in the journal JAMA.
This is the first randomised trial to compare micro-ultrasound (microUS) guided biopsy with MRI-guided biopsy for prostate cancer. It involves 677 men who underwent biopsy at 19 hospitals across Canada, the USA and Europe.
Of these, half underwent MRI-guided biopsy, a third received microUS-guided biopsy followed by MRI-guided biopsy and the remainder received microUS-guided biopsy alone.
MicroUS was able to identify prostate cancer as effectively as MRI-guided biopsy, with very similar rates of detection across all three arms of the trial.
There was little difference even in the group who received both types of biopsies, with the microUS detecting the majority of significant cancers, the authors noted.
MRI-guided biopsy requires a two-step process (the MRI scan, followed by the ultrasound-guided biopsy), requiring multiple hospital visits and specialist radiological expertise to interpret the MRI images and fuse them onto the ultrasound.
Micro-ultrasound has higher frequency than conventional ultrasound, resulting in three times greater resolution images that can capture similar detail to MRI scans for targeted biopsies.
Clinicians such as urologists and oncologists can be easily trained to use the technique and interpret the images, especially if they have experience in conventional ultrasound.
Laurence Klotz, Professor of Surgery at the University of Toronto’s Temerty Faculty of Medicine, said 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,” he noted.
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