Micro-Ultrasound Shows MRI-Level Accuracy In Detecting Prostate Cancer (Image Credits: iStock)
An international clinical trial has demonstrated that high-resolution micro-ultrasound is just as effective as MRI in diagnosing prostate cancer. The study, known as the OPTIMUM trial, suggests that this technology could revolutionize prostate cancer detection by offering a more affordable, faster, and accessible alternative to MRI-guided biopsies.
The findings were presented on March 23, 2025, at the European Association of Urology Congress in Madrid and were published in the Journal of the American Medical Association (JAMA). Researchers believe that micro-ultrasound could reduce hospital visits, free up valuable MRI resources, and speed up the diagnosis process for prostate cancer patients.
A Game-Changer in Prostate Cancer Detection
The OPTIMUM trial is the first randomized clinical trial to compare micro-ultrasound (microUS)-guided biopsy with MRI-guided biopsy for prostate cancer. The study analyzed 677 men who underwent biopsies at 19 hospitals across Canada, the United States, and Europe.
Participants were divided into three groups:
50 per cent underwent MRI-guided biopsy,
The study found no significant difference in cancer detection rates among the groups, proving that micro-ultrasound can detect prostate cancer as effectively as MRI-guided biopsies. Even in cases where both techniques were used together, microUS identified the majority of significant cancers, suggesting that MRI may not always be necessary for accurate diagnosis.
Advantages of Micro-Ultrasound Over MRI
Currently, around a million prostate cancer biopsies are performed annually in Europe and the US, with approximately 100,000 in Canada. The MRI-guided biopsy process involves a two-step procedure:
An MRI scan to identify suspicious areas.
This method requires multiple hospital visits, specialized radiologists, and expensive MRI scans. Additionally, not all patients can undergo MRI, particularly those with metal implants like hip replacements or pacemakers.
Micro-ultrasound, on the other hand, operates at a higher frequency than conventional ultrasound, producing three times higher resolution images. This allows doctors to capture MRI-level detail in real time, making targeted biopsies more accessible. The advantages of microUS include:
Lower cost compared to MRI.
Expert Take on the Impact of the Findings
Professor Laurence Klotz, lead researcher of the trial and Professor of Surgery at the University of Toronto, emphasized the importance of this breakthrough.
"MRI was a game-changer when it first emerged, allowing targeted biopsies with greater accuracy. However, MRI has limitations—it’s expensive, difficult to access, and requires expertise for interpretation," he explained.
He further noted that microUS eliminates these issues by providing equal diagnostic accuracy, a one-stop-shop approach, and greater accessibility, allowing hospitals to prioritize MRI for other critical uses like orthopaedic imaging.
Professor Jochen Walz, a leading expert in urological imaging from the Institut Paoli-Calmettes Cancer Center in France, also highlighted the benefits.
"Micro-ultrasound is a more straightforward and safer alternative, avoiding potential errors that can occur when fusing MRI to ultrasound for biopsy. Although training is required to interpret microUS images, it allows for prostate cancer diagnosis and biopsy to be performed in a single visit," he stated.
He further suggested that microUS could play a vital role in prostate cancer screening programs, particularly in developing healthcare systems, where MRI availability is limited. However, additional research is needed to explore its full potential in large-scale screening efforts.
A Step Toward More Accessible Cancer Diagnosis
The trial was sponsored by Exact Imaging, a Canadian company specializing in microUS technology. As healthcare providers continue to seek cost-effective and efficient diagnostic methods, micro-ultrasound presents a promising solution for faster, cheaper, and equally reliable prostate cancer detection.
With its ability to simplify biopsy procedures, increase accessibility, and reduce reliance on MRI, micro-ultrasound may soon become a standard tool in prostate cancer diagnostics, transforming the way millions of men worldwide are screened and treated for the disease.
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