Presentation Authors: Francesco Chessa*, Riccardo Schiavina, Eugenio Brunocilla, Borghesi Marco, Lorenzo Bianchi, Cristian Pultrone, Amelio Ercolino, Davide Giusti, Bologna, Italy, Luca Lodigiani, Italy, Italy, Caterina Gaudiano, Eugenio Brunocilla, Bologna, Italy
Introduction: Although multiparametric MRI (mpMRI) is the most accurate tool in the detection of clinically significant Prostate Cancer (CsPCa), some limitations have reduced its use as a triage test. ExactVu is a real-time micro-ultrasound system capable of providing 300% higher resolution compared to conventional trans rectal ultrasound. Similarly to mpMRI in which PIRADS protocol has been developed to standardize the likelihood of PCa risk, a novel protocol of risk identification called PRI-MUS, is being developed to provide the same intended benefits for micro-ultrasound. The aim of our study was to evaluate the performance of ExactVu in the detection of CsPCa.
Methods: Patients with PCa diagnosed at fusion biopsy were imaged with ExactVu. CsPCa was defined as any Gleason Score â‰¥3+4. ExactVu examination was considered as positive when PRI-MUS score was â‰¥3. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operator characteristic (ROC) curve (AUC) were calculated.
Results: 57 patients out of 68 (84%) had a csPCa. A detailed list of clinical, radiological and pathological characteristics of patients is reported in table 1a. PRI-MUS score was correctly assessed in 57% of cases (table 1 b). Regarding the detection of CsPCa (Fig. 1a), ExactVu&[prime]s sensitivity, specificity, PPV, and NPV was 68%, 73%, 93%, and 31%, respectively and the AUC was 0.7 (95% CI 0.5-0.8). Detecting CsPCa in the transition/anterior zone (Fig.1 b) the sensitivity, specificity, PPV, and NPV was 45 %, 66 %, 83 % and 25 % respectively ant the AUC was 0.5 (95% CI 0.2-0.9). Accounting only the CsPCa located in the peripheral zone (Fig. 1c), sensitivity, specificity, PPV, and NPV raised up to 74%, 75%, 94%, 33%, respectively with AUC 0.75 (95% CI 0.5-0.9).
Conclusions: ExactVu provides high resolution of the prostatic peripheral zone and could represent a step forward in the detection of CsPCa in a triage setting.