By Deb Hickey
In last month’s BOB Tales, the growing role of PSMA PET/CT scans was highlighted as a breakthrough tool for spotting prostate cancers that MRI-guided biopsies can miss. Now, high-resolution micro-ultrasound (microUS) is emerging as another valuable option in prostate cancer diagnosis.
While MRI remains the gold standard for guiding biopsies, it’s not always an option—especially for men with implanted devices like pacemakers, severe claustrophobia, or limited access to advanced imaging centers. Insurance hurdles can also complicate matters: Many plans require pre-approval, restrict coverage to specific criteria, or burden patients with high out-of-pocket costs. And in some regions, MRI appointments are difficult to schedule, leading to frustrating delays in diagnosis and care.
MicroUS, by contrast, can be performed in a urologist’s office in real time—without sedation, radiation, or significant wait times. Recent clinical trials suggest that microUS may match MRI in its ability to detect suspicious areas during biopsy, offering high-resolution imaging that helps physicians target areas precisely and avoid unnecessary procedures.
While PSMA PET/CT is currently the most sensitive imaging tool available, it’s expensive, less accessible, and not generally used as a first-line test. MRI is more widely adopted but not always feasible. MicroUS presents a practical, lower-cost alternative—especially in settings where access to advanced imaging is limited. Rather than replacing more advanced tools, microUS may serve as a complementary option within the diagnostic pathway. It provides doctors with an immediate, in-office method to pinpoint areas of concern, while MRI and PSMA PET/CT remain important for more complex or ambiguous cases.
Together, these imaging technologies offer a more flexible and comprehensive approach to detecting prostate cancer early and accurately.
Deb Hickey and Bob Marckini manage the Brotherhood of the Balloon (BOB), a 10,000-member organization of prostate cancer patients from all 50 states and 39 countries, in December 2000. Learn more about BOB.