‘Game-changing’ ultrasound can spot prostate cancer after just one biopsy scan, trial suggests

Biopsies guided by high-resolution ultrasound could speed-up the diagnosis of prostate cancer, a major trial suggests.

The ‘game-changing’ technology proved just as effective as MRI at diagnosing the disease but was cheaper and easier to use, researchers said.

It could allow doctors to provide a ‘one-stop shop’ where patients can be scanned and biopsied immediately in one hospital visit.

Most biopsies are currently conducted in a two-step process across multiple visits.

Adopting the new tool, named micro-ultrasound – or microUS – would free-up scarce MRI scanners for other uses, experts added.

It is the first randomised trial to compare microUS procedures with MRI ones specifically for prostate cancer.

As part of the trial, 677 men underwent biopsy at 19 hospitals across Canada, the US and Europe. Half had an MRI-guided biopsy, a third received microUS-guided biopsy followed by MRI and the remainder had microUS alone.

Cancer in this third group was identified as effectively as MRI-guided biopsy, with similar rates of detection across all arms of the trial.

Prostate cancer is the most diagnosed form of cancer in England, with 55,033 cases identified in 2023, the latest figures show.

The Mail has fought for nearly 25 years to raise the profile of prostate cancer to save lives through better diagnosis and treatments. Now clinicians such as urologists and oncologists can be easily trained to use the technique and interpret images.

The results of the Optimum trial were presented yesterday at the European Association of Urology Congress in Madrid and published in the Journal of the American Medical Association.

Micro-ultrasound has a higher frequency than conventional ultrasound, boosting the resolution of its images three-fold and allowing them to capture similar detail to MRI scans for targeted biopsies.

Following the breakthrough, lead researcher Professor Laurence Klotz, from the University of Toronto, said the trial results could have a similar impact to the first introduction of MRI.

He said: ‘When MRI first emerged and you could image prostate cancer accurately for the first time to do targeted biopsies, that was a game-changer.

‘But MRI isn’t perfect. It’s expensive. It can be challenging to get access to it quickly. It requires a lot of experience to interpret properly. It uses gadolinium which has some toxicity.

‘Not all patients can have MRI, if they have replacement hips or pacemakers for example.

‘But we now know microUS can give as good a diagnostic accuracy as MRI. That is game-changing.

‘It means you can offer a one-stop shop, where patients are scanned, then biopsied immediately if required.’