Earlier this week, researchers presented data from the OPTIMUM (Optimization of Prostate Biopsy – Micro-Ultrasound Versus MRI) trial at the European Association of Urology Congress in Madrid, Spain. Results of the study, recently published in the Journal of the American Medical Association, demonstrate a new approach to biopsy prostate tissue when screening for cancer.
To perform prostate cancer biopsies, doctors use a technology called MRI fusion-guided biopsy. This technique combines MRI with a transrectal ultrasound to more precisely sample prostate tissue. The OPTIMUM trial compared MRI fusion-guided biopsy to another ultra-high resolution transrectal micro-ultrasound (microultrasonography-guided biopsy). Using higher frequency sound waves than traditional ultrasound technologies, microultrasonography-guided biopsy allows improved image quality to healthcare professionals performing prostate biopsies.
A team of doctors from 20 medical centers across eight countries (Canada, Europe, and the United States) collaborated to conduct the OPTIMUM trial. The trial team recruited men suspected of prostate cancer, based on either elevated prostate-specific antigen (PSA) or an abnormal digital rectal examination, to enroll in the study. None of the participants had received a prostate biopsy previously.
Upon enrollment, participants were randomly assigned to receive one of three biopsy procedures: 1) microultrasonography-guided biopsy (mUS), 2) microultrasonography/MRI fusion-guided biopsy (mUS/MRI), or 3) MRI/conventional US fusion-guided biopsy (MRI/cUS). In addition, all patients received a systematic biopsy where several samples from the prostate are removed for visualization under a microscope.
To assess differences between the techniques, the researchers compared the number of Gleason Grade Group (GGG) 2 or higher cancers detected using mUS and MRI/cUS and between mUS/MRI and MRI/cUS.
A total of 678 men (average age of 65) enrolled and underwent biopsy. The analysis found a similar percentage of patients diagnosed with GGG 2 or higher prostate cancer between groups (47.1% in mUS, 46.9% in mUS/MRI, and 42.6% in MRI/cUS. The findings present mUS as an accurate and feasible alternative to biopsy approaches requiring MRI.
Increasing the usage of mUS could have many advantages, including increasing accessibility to more patients, as not everyone can undergo an MRI procedure. Further, since MRI equipment is not available at every medical center, it often requires multiple medical appointments for patients. However, patients could quickly undergo mUS procedures in most medical offices and accelerate the time to diagnosis.
Sources: JAMA
