This systematic review and diagnostic test accuracy meta-analysis looked at five prospective studies. The researchers evaluated standalone 29-MHz micro-ultrasound as a way to classify clinically significant prostate cancer. They used histopathology as the reference standard to check the accuracy of the scans. The studies involved patients going through a diagnostic pathway for prostate cancer assessment.
The analysis found that the test had a sensitivity of 0.84. This means it correctly identified most cases of significant cancer. However, the specificity was lower at 0.41. This indicates the test might flag some cases that do not have significant cancer.
The results showed a modest impact on post-test probability. A positive test shifted the probability by about 33 percent, while a negative test shifted it by about 11 percent. The study noted substantial heterogeneity among the studies and that results were influenced by different clinical thresholds.
Readers should understand that this tool works best as a complementary triage or rule-out adjunct. It is particularly useful when mpMRI is unavailable, contraindicated, or delayed. The evidence supports its use in these specific situations, but larger multicenter studies are needed to standardize thresholds and training.