PROSTATE CANCER

When people are asked to get an MRI, a test used to diagnose cancer, one thing that comes to mind and makes them nervous is being asked to do so. However, new research has discovered that an ultrasound scan can be used to diagnose cancer. Ultrasound testing were found to be effective in detecting cases of prostate cancer in the study.

In a clinical experiment involving 370 men, researchers from Imperial College London, University College London, and Imperial College Healthcare NHS Trust discovered that a novel form of ultrasound scan may accurately diagnose most prostate cancer cases.

When compared to magnetic resonance imaging (MRI) scans currently used to diagnose prostate cancer, ultrasound scans missed only 4.3 percent more clinically relevant prostate cancer cases – cancer that should be treated rather than observed.

MRI scans are costly and time-consuming procedures. The researchers feel that an ultrasound scan should be utilised as a first test in community health settings and in low- and middle-income nations where high-quality MRI scans are difficult to come by.

It might be used in conjunction with current MRI scans to improve cancer diagnosis, according to the researchers. “Prostate cancer is the most often diagnosed malignancy in the UK,” said Professor Hashim Ahmed, the study’s principal author and Chair of Urology at Imperial College London. In their lifetimes, one out of every six males will be diagnosed with the disease, and that number is anticipated to climb.”

“One of the techniques we employ to diagnose prostate cancer is an MRI scan. These scans, while helpful, are costly, take up to 40 minutes to complete, and are not readily available to everyone. Furthermore, some individuals, such as those with hip replacements or claustrophobia phobias, are unable to have MRI scans. As cancer waiting lists build as a result of the COVID-19 pandemic, there is a real need to find more efficient and cheaper tests to diagnose prostate cancer,” he added.

“Our study is the first to show that a special type of ultrasound scan can be used as a potential test to detect clinically significant cases of prostate cancer. They can detect most cases of prostate cancer with good accuracy, although MRI scans are slightly better,” he said.

“We believe this test can be employed in poor and middle-income regions where access to pricey MRI equipment is limited and prostate cancer diagnoses are on the rise,” he said.

With roughly 52,300 new cases diagnosed each year, prostate cancer is the most frequent cancer in men in the UK. It occurs when cells in the prostate grow out of control. The symptoms of prostate cancer, such as blood in the urine, do not present until the disease has progressed. Males over the age of 50 are more likely to be affected, as are men with a family history of the disease. The disease affects black males disproportionately, and prostate cancer mortality have now surpassed breast cancer deaths.

The current study looked at the use of multi-parametric ultrasound (mpUSS), a type of imaging that employs sound waves to look at the prostate. The images of the prostate were taken with the help of a tool called a transducer. It is implanted in the rectum and emits sound waves that are reflected by organs and other tissues. These are then turned into organ pictures.

The doctor who performed the test also employed extra-special sorts of ultrasound imaging to assess the stiffness of the tissue and the amount of blood flow it has. Elastography, doppler, and contrast-enhancement with microbubbles are examples of these techniques. Cancers show up more vividly because they are thicker and have a higher blood supply.

Despite the fact that mpUSS is more commonly available than mpMRI, no large-scale research have been conducted to evaluate its usefulness as a test for detecting prostate cancer cases.

The team recruited 370 men at risk of prostate cancer for the new study, dubbed cancer diagnosis by multiparametric ultrasonography of the prostate (CADMUS). Initial tests such as a prostate-specific antigen (PSA) test, which is a blood test used to detect prostate cancer, and/or an abnormal digital rectal examination, which examines a person’s lower rectum, pelvic, and lower belly, were used to identify them. Between March 2016 and November 2019, the study took place at seven hospitals in the UK, including the principal site Charing Cross Hospital, which is part of Imperial College Healthcare NHS Trust.

At different trips, the males received mpUSS and mpMRI scans. Biopsies were subsequently performed on 257 patients who had a positive mpUSS or mpMRI test result, which involved taking small samples of tissue from the prostate with fine needles to examine under a microscope for malignancy. The findings of the tests were then compared by the team.

A total of 133 males were found to have cancer, with 83 of them being diagnosed with clinically severe malignancy.
Individually, mpUSS found 66 cases of clinically serious cancer against 77 cases for mpMRI.
Despite the fact that mpUSS discovered 4.3 percent less clinically significant prostate tumours than mpMRI, the researchers estimated that this approach would result in 11.1 percent more individuals being biopsied.

This was due to the fact that the mpUSS occasionally appeared in aberrant regions even when there was no malignancy.

The researchers feel that the test can be utilised as a first test for patients at risk of prostate cancer as an alternative to mpMRI, especially in cases when mpMRI is not possible. Both imaging methods missed clinically significant cancers found by the other, hence using both would boost the detection of clinically significant prostate cancers when compared to using each test separately.

“Our results provide an accurate test for prostate cancer in people who were previously without one using a scan that is affordable and straightforward to do,” stated Dr. Alistair Grey (UCL Division of Surgery and Interventional Science).