Evaluating the Role of Ultrasound in Prostate Cancer trial - phase 1: Early experience of micro-ultrasound in the United Kingdom.

Purpose: The purpose of this study was to evaluate if the use of micro-ultrasound can detect clinically significant prostate pathology when compared to histology obtained during a transperineal prostate biopsy. Methods: Patients suspected of having prostate cancer, who had a pre-biopsy magnetic resonance imaging and could tolerate a transrectal examination, were prospectively recruited. All patients had a micro-ultrasound scan prior to their biopsy. The findings of magnetic resonance imaging, micro-ultrasound and histology were risk stratified in accordance with local pathways. Comparison of assigned risk scores was made using histology as the reference standard. Results: Data from 101 patients were evaluated. Histology showed that clinically significant prostate cancer was detected in 48.5% ( Conclusion: A limitation of this study was that the biopsy was not performed with micro-ultrasound which may have resulted in unidentified cancers and lowered the apparent accuracy of the technique. However, we conclude that while micro-ultrasound was diagnostic, magnetic resonance imaging demonstrated higher sensitivity in our local population and remains the pre-biopsy imaging modality of choice. However, the higher specificity of micro-ultrasound identified does indicate that it may be of value when magnetic resonance imaging is contraindicated. The role of micro-ultrasound, within an active surveillance pathway for prostate cancer, warrants further investigation.