Ultrasound can spot prostate cancers

Multiparametric ultrasound helps detect clinically significant prostate cancers, although magnetic resonance imaging (MRI) scans are slightly better, as reported in a study.

A total of 306 men with an elevated prostate-specific antigen concentration or abnormal findings on digital rectal examination completed both multiparametric ultrasound and multiparametric MRI. The ultrasound included B-mode, colour Doppler, real-time elastography, and contrast-enhanced ultrasound. On the other hand, the MRI consisted of high-resolution T2-weighted images, diffusion-weighted imaging, and dynamic contrast-enhanced axial T1-weighted images.

Of the participants, 257 had positive findings on either imaging modality and subsequently underwent a prostate biopsy. Multiparametric ultrasound yielded positive findings in 272 of 306 men (89 percent), while multiparametric MRI did so in 238 men (78 percent). The resulting positive test agreement was 73.2 percent.

Any cancer was detected in 133 of 257 men (52 percent), with 83 (32 percent) having clinically significant disease (defined as a Gleason score of ≥4 + 3 in any area, or a maximum cancer core length of ≥6 mm of any grade). Used alone, ultrasound and MRI detected clinically significant cancer in 66 (26 percent) and 77 (30 percent) men, respectively.

When the tests were combined, clinically significant cancers were detected in 83 of 257 men (32 percent), of whom six (7 percent) had their condition detected exclusively with ultrasound and 17 with MRI (agreement 91.1 percent).

None of the men developed serious adverse events related to trial activity.

The findings indicate that the use of both imaging modalities would increase the detection of clinically significant prostate cancers compared with the use of each test alone. However, researchers believe that ultrasound can be used in low- and middle-income settings where access to expensive MRI equipment is difficult.