THE RESULTS of the OPTIMUM trial, presented at the European Association of Urology (EAU) Congress 2025, have demonstrated that micro-ultrasound (microUS) guided biopsies are as effective as MRI-guided biopsies in diagnosing prostate cancer, potentially revolutionising the diagnostic process for this common cancer.
Prostate cancer diagnosis traditionally relies on MRI-guided biopsies, which require multiple hospital visits and specialised radiological expertise. The OPTIMUM trial compared microUS-guided biopsies with MRI-guided biopsies in 677 men across 19 hospitals in Canada, the USA, and Europe. The study found that microUS was equally effective in identifying prostate cancer, with similar detection rates across all three trial arms.
MicroUS operates at 29 MHz, providing a 300% improvement in resolution compared to conventional ultrasound. This higher resolution allows real-time visualisation of suspicious areas, comparable to MRI scans. The trial showed that microUS detected the majority of significant cancers, even in the group that received both types of biopsies. Importantly, microUS is cheaper, easier to use, and more accessible than MRI, potentially enabling same-day imaging and biopsy in a single appointment.
These findings could significantly impact prostate cancer diagnosis and management. MicroUS could streamline the diagnostic process, reducing waiting times and hospital visits while freeing up MRI resources for other uses. It also offers advantages for patients unsuitable for MRI due to metal implants or claustrophobia. However, proper training in image interpretation is crucial for optimal results. Future research should focus on microUS’s potential role in screening programmes and its long-term impact on patient outcomes. As healthcare systems adopt this technology, it could democratise access to advanced prostate cancer diagnostics, particularly in regions where MRI availability is limited.
Reference
Klotz LH et al. Micro-ultrasound-guided vs MRI-guided biopsy for prostate cancer: the OPTIMUM randomized trial. EAU Annual Congress, 23 March, 2025.
