Microultrasonography-guided vs MRI-guided biopsy for prostate cancer diagnosis

A recent study published in JAMA investigates the efficacy of high-resolution microultrasonography (microUS)-guided biopsy compared to MRI fusion-guided biopsy in diagnosing prostate cancer. This research is particularly significant for urologists and oncologists seeking alternative diagnostic tools for prostate cancer detection.

The study enrolled men with clinical indications for prostate biopsy, including elevated prostate-specific antigen (PSA) levels or abnormal digital rectal examination findings. Participants underwent both microUS-guided and MRI fusion-guided biopsies, allowing for a direct comparison of the two techniques.

Key Findings

• Diagnostic Accuracy: MicroUS-guided biopsy demonstrated comparable accuracy to MRI fusion-guided biopsy in detecting clinically significant prostate cancer.

• Procedure Efficiency: MicroUS-guided biopsy was associated with shorter procedure times, suggesting potential benefits in clinical workflow and patient comfort.​

• Accessibility: MicroUS technology offers a more accessible and cost-effective alternative to MRI, which may be particularly advantageous in settings with limited MRI availability.

The findings suggest that microUS-guided biopsy could serve as a viable alternative to MRI fusion-guided biopsy for prostate cancer diagnosis. Its comparable accuracy, coupled with increased efficiency and accessibility, positions microUS as a valuable tool in the diagnostic arsenal for prostate cancer.

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This study highlights the potential of high-resolution microultrasonography as an effective and practical approach for prostate cancer biopsy guidance. Further research and long-term follow-up are warranted to confirm these findings and to explore the integration of microUS into standard clinical practice.

Paper: Kinnaird A, Luger F, Cash H, et al. Microultrasonography-Guided vs MRI-Guided Biopsy for Prostate Cancer Diagnosis: The OPTIMUM Randomized Clinical Trial. JAMA. Published online March 23, 2025. doi:10.1001/jama.2025.3579