Abstract
Introduction:
Microultrasound is a high-resolution ultrasound technology operating at 29 MHz, enabling live visualization of prostate tissue and cognitive-fusion transperineal biopsy.1,2 Suspicious lesions are assessed using the Prostate Risk Identification Using Micro-Ultrasound (PRI-MUS) scoring system (score 1–5), which correlates with Prostate Imaging–Reporting and Data System (PI-RADS).3,4 Microultrasound-guided prostate biopsy has emerged as a noninferior alternative to MRI-targeted biopsy for detecting clinically significant prostate cancer. 1 This video showcases our clinical experience with microultrasound-guided cognitive transperineal prostate biopsy.
Materials and Methods:
Under general anesthesia (GA), patients are placed in lithotomy position with the scrotum elevated and perineum exposed. Fifty milliliters of ultrasound gel is inserted into the rectum to improve imaging. After skin cleansing, the Micro-US probe is inserted rectally and positioned to center the mid-prostate. The probe is swept laterally to visualize the prostate sagittally and calculate its volume. Transitional and peripheral zones are assessed using PRI-MUS, and lesions with scores ≥3 are targeted. The procedure can also be performed under local anesthesia (LA) by anesthetizing the perineal soft tissues and peri-apical triangle.
Results:
Between January and April 2025, 34 patients underwent the procedure—33 under GA and one under LA. The mean age of the cohort was 67.0 years, and 94.2% were Chinese. The mean operative time was 15.1 minutes. PRI-MUS 3 lesions accounted for 7.9% of biopsies, compared to PRI-MUS 4 (44.4%) and PRI-MUS 5 (47.7%). All patients were discharged the same day without complications.
Conclusion:
MUB is a safe and noninferior diagnostic tool that can be reproducibly performed under either GA or LA.
The authors declare no commercial associations during the last 2 years that might create a conflict of interest in connection with the video.
The authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
Runtime of video:
4 mins 49 secs.