Advanced ultrasound in the diagnosis of prostate cancer

The diagnosis of prostate cancer (PCa) can be challenging due to the limited performance of current diagnostic tests, including PSA, digital rectal examination and transrectal conventional US. Multiparametric MRI has improved PCa diagnosis and is recommended prior to biopsy; however, mp-MRI does miss a substantial number of PCa. Advanced US modalities include transrectal prostate elastography and contrast-enhanced US, as well as improved B-mode, micro-US and micro-Doppler techniques. These techniques can be combined to define a novel US approach, multiparametric US (mp-US). Mp-US improves PCa diagnosis but is not sufficiently accurate to obviate the utility of mp-MRI. Mp-US using advanced techniques and mp-MRI provide complementary information which will become even more important in the era of focal therapy, where precise identification of PCa location is needed.

Automated summary

The current diagnosis of prostate cancer is limited by the performance of existing tests, but a combination of multiparametric MRI and advanced ultrasound techniques like mp-US can improve diagnostic accuracy. While mp-US enhances PCa diagnosis, it is not accurate enough to replace mp-MRI, and a combination of the two methods provides complementary information that is crucial in the era of focal therapy.