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10.01.2022 | Original Article

Use of high-resolution micro-ultrasound to predict extraprostatic extension of prostate cancer prior to surgery: a prospective single-institutional study

verfasst von: Vittorio Fasulo, Nicolò Maria Buffi, Federica Regis, Marco Paciotti, Fancesco Persico, Davide Maffei, Alessandro Uleri, Alberto Saita, Paolo Casale, Rodolfo Hurle, Massimo Lazzeri, Giorgio Guazzoni, Giovanni Lughezzani

Erschienen in: World Journal of Urology | Ausgabe 2/2022

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Abstract

Purpose

We aim to evaluate the accuracy of micro-ultrasound (microUS) in predicting extraprostatic extension (EPE) of Prostate Cancer (PCa) prior to surgery.

Methods

Patients with biopsy-proven PCa scheduled for robot-assisted radical prostatectomy (RARP) were prospectively recruited. The following MRI-derived microUS features were evaluated: capsular bulging, visible breach of the prostate capsule (visible extracapsular extension; ECE), presence of hypoechoic halo, and obliteration of the vesicle-prostatic angle. The ability of each feature to predict EPE was determined.

Results

Overall, data from 140 patients were examined. All predictors were associated with non-organ-confined disease (p < 0.001). Final pathology showed that 79 patients (56.4%) had a pT2 disease and 61 (43.3%) ≥ pT3. Rate of non-organ-confined disease increased from 44% in those individuals with only 1 predictor (OR 7.71) to 92.3% in those where 4 predictors (OR 72.00) were simultaneously observed. The multivariate logistic regression model including clinical parameters showed an area under the curve (AUC) of 82.3% as compared to an AUC of 87.6% for the model including both clinical and microUS parameters. Presence of ECE at microUS predicted EPE with a sensitivity of 72.1% and a specificity of 88%, a negative predictive value of 80.5% and positive predictive value of 83.0%, with an AUC of 80.4%.

Conclusions

MicroUS can accurately predict EPE at the final pathology report in patients scheduled for RARP.

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Titel: Use of high-resolution micro-ultrasound to predict extraprostatic extension of prostate cancer prior to surgery: a prospective single-institutional study
verfasst von: Vittorio Fasulo
Nicolò Maria Buffi
Federica Regis
Marco Paciotti
Fancesco Persico
Davide Maffei
Alessandro Uleri
Alberto Saita
Paolo Casale
Rodolfo Hurle
Massimo Lazzeri
Giorgio Guazzoni
Giovanni Lughezzani
Publikationsdatum: 10.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 2/2022
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03890-4

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Use of high-resolution micro-ultrasound to predict extraprostatic extension of prostate cancer prior to surgery: a prospective single-institutional study