Head-to-head Comparison of Multimodal Imaging for Prostate Cancer Detection and Local Staging with…

Cohort studyEuropean urology oncology· Jun 2026

Head-to-head Comparison of Multimodal Imaging for Prostate Cancer Detection and Local Staging with Whole-mount Histopathology Reference.

Qi Miao, Anthony Sisk, Ida Sonni … KyungHyun Sung

Surgical PathologyCohort studyDiagnosisQ1IF 5.9

MRI had higher positive predictive value than microultrasound for significant prostate cancer

Head-to-head Comparison of Multimodal Imaging for Prostate Cancer Detection and Local Staging with Whole-mount Histopathology Reference.

Qi Miao … KyungHyun Sung

European urology oncology · Jun 2026 · Q1 in General Medicine

Background

Accurate detection and local staging of prostate cancer (prostate cancer) remain critical for treatment planning, yet head-to-head multimodal imaging comparisons remain limited.

Purpose

This study compared microultrasound (microUS), multiparametric magnetic resonance imaging (mpMRI), and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for detecting clinically significant prostate cancer (csPCa) and extraprostatic extension (extraprostatic extension), using whole-mount histopathology (whole-mount histopathology) as the reference standard.

Methods

DESIGN, SETTING, AND PARTICIPANTS: This retrospective study included patients who underwent microUS and mpMRI followed by radical prostatectomy between January 2023 and October 2024.

Results

MRI positive readings for significant cancer were correct more often than microultrasound's

mpMRI

0.91PPV

microUS

0.77PPV

More results

Across modalities, 15-18% of csPCa lesions were missed, which were non-index Grade Group 2 with Gleason pattern 4 ≤20%.

The study is limited by its single-center retrospective design.

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Conclusion

MicroUS showed no statistically significant differences compared with mpMRI and PSMA PET/CT for detecting index and csPCa lesions, supporting a potential complementary role in resource-limited or MRI-contraindicated settings.