@Article{cju.2026.079661,
AUTHOR = {Daniel Ajabshir, Adriana Pedraza, Ash Tewari},
TITLE = {The role of micro-ultrasound in active surveillance for prostate cancer},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {},
YEAR = {},
NUMBER = {},
PAGES = {{pages}},
URL = {http://www.techscience.com/CJU/online/detail/27294},
ISSN = {1488-5581},
ABSTRACT = {Active surveillance (AS) requires reliable imaging to detect grade progression in low-risk prostate cancer. This narrative review evaluates the role of high-resolution micro-ultrasound (micro-US) in AS and its integration with multiparametric magnetic resonance imaging (mpMRI). A targeted synthesis of randomized trials, prospective cohorts, and meta-analyses through December 2025 was performed. The OPTIMUM randomized trial demonstrated non-inferiority of micro-US–guided biopsy for detecting Grade Group 2 or higher cancer. In AS cohorts, micro-US shows high sensitivity (94–97%) and negative predictive value (88–97%) for detecting grade reclassification. These findings support its role as a real-time targeting modality and as a triage tool to reduce unnecessary biopsies, particularly in MRI-limited or discordant settings. Limitations include operator dependence, inter-reader variability, and evolving performance in anterior-zone assessment influenced by training and emerging protocols. Overall, micro-US represents a complementary modality within AS pathways, with ongoing trials expected to define its role in longitudinal surveillance.},
DOI = {10.32604/cju.2026.079661}
}