Imperial College Academic Health Science Centre News Release
Under STRICT embargo until:
Monday 28 February 2022
23.30 GMT/18.30 EST
Ultrasound scan can diagnose prostate cancer
An ultrasound scan can be used to detect cases of prostate cancer, according to new research.
Researchers at Imperial College London, University College London and Imperial College Healthcare NHS Trust have found that a new type of ultrasound scan can diagnose most prostate cancer cases with good accuracy in a clinical trial involving 370 men.
The ultrasound scans missed only 4.3 per cent more clinically important prostate cancer cases – cancer that should be treated rather than monitored – compared to magnetic resonance imaging (MRI) scans currently used to detect prostate cancer.
MRI scans are expensive and time-consuming. The team believes that an ultrasound scan should be used as a first test in a community healthcare setting and in low and middle income countries which do not have easy access to high quality MRI scans. They say it could be used in combination with current MRI scans to maximise cancer detection. The study is published in Lancet Oncology.
Professor Hashim Ahmed, lead author of the study and Chair of Urology at Imperial College London, said:
“Prostate cancer is the most commonly diagnosed cancer in the UK. One in six men will be diagnosed with the disease in their lifetimes and that figure is expected to rise.
“MRI scans are one of the tests we use to diagnose prostate cancer. Although effective these scans are expensive, take up to 40 minutes to perform and are not easily available to all. Also, there are some patients who are unable to have MRI scans such as those with hip replacements or claustrophobia fears. As cancer waiting lists build as a result of the COVID-19 pandemic, there is a real need to find more efficient and cheaper tests to diagnose prostate cancer.
“Our study is the first to show that a special type of ultrasound scan can be used as a potential test to detect clinically significant cases of prostate cancer. The can detect most cases of prostate cancer with good accuracy, although MRI scans are slightly better.
“We believe that this test can be used in low and middle income settings where access to expensive MRI equipment is difficult and cases of prostate cancer are growing.”
Prostate cancer is the most common cancer in men in the UK with around 52,300 new cases diagnosed each year. It develops when cells in the prostate grow in an uncontrolled way. Prostate cancer develops slowly and symptoms such as the blood in the urine do not appear until the disease has developed. It usually affects men over 50 and often men with a family history of the disease. Black men are disproportionately impacted by the disease and deaths from prostate cancer have now overtaken those from breast cancer.
One of the main methods to diagnose prostate cancer is a special type of magnetic resonance Imaging (MRI) scan called a multi-parametric MRI (mpMRI) scan, which helps doctors see if there is any cancer inside the prostate and how quickly the cancer is likely to grow. However, the scan takes 40 minutes and costs £350-450.
The new study looked at the use of a different kind of imaging called multiparametric ultrasound (mpUSS), which uses soundwaves to look at the prostate. The test involves the use of a probe called a transducer to make the images of the prostate. It is placed into the rectum and it sends out sound waves that bounce off organs and other structures. These are then made into pictures of the organs.
The doctor doing the test also uses extra special types of ultrasound imaging that look at how stiff the tissue is and how much blood supply tissue has. These are called elastography, doppler and contrast-enhancement with microbubbles. As cancers are more dense and have greater blood supply, they show up more clearly.
Although mpUSS is more widely available than mpMRI there has been no large-scale studies to validate its effectiveness as a test to detect prostate cancer cases.
In the new trial, called cancer diagnosis by multiparametric ultrasound of the prostate (CADMUS), the team recruited 370 men at risk of prostate cancer. They were identified following initial tests such as a prostate-specific antigen (PSA) test– a blood test to help detect prostate cancer – and/or an abnormal digital rectal examination - a test that examines a person's lower rectum, pelvis, and lower belly.
The study took place at seven hospitals in the UK including lead site Charing Cross Hospital, part of Imperial College Healthcare NHS Trust, between March 2016-November 2019.
The men were given both mpUSS and mpMRI scans at separate visits. This was then followed by biopsies - which involves using thin needles to take small samples of tissue from the prostate to analyse under a microscope to check cancer – for 257 patients who had a positive mpUSS or mpMRI test result. The team then compared the results from the tests.
Cancer was detected in 133 men, with 83 men diagnosed with clinically significant cancer.
Individually, mpUSS detected 66 cases of clinically significant cancer compared to mpMRI which detected 77 cases.
Although mpUSS detected 4.3 per cent fewer clinically-important prostate cancers compared to mpMRI the researchers said this method would lead to 11.1 per cent more patients being biopsied. This was because the mpUSS sometimes showed up abnormal areas even though there was no cancer.
The researchers believe that the test can be used as an alternative to mpMRI as a first test for patients at risk of prostate cancer, particularly where mpMRI cannot be carried out. Both imaging tests missed clinically-important cancers detected by the other, so using both would increase the detection of clinically-important prostate cancers compared to using each test alone.
First author, Dr Alistair Grey (UCL Division of Surgery & Interventional Science), said:
“Our results provide an accurate test for prostate cancer in patients who were previously without one using a scan that’s cheap and easy to conduct.”
The trial was funded by The Jon Moulton Charity Trust and Prostate Cancer UK.
For more information, please contact:
AHSC Communications Manager
Imperial College London
Tel: +44 (0) 7561 451724
Duty press officer mobile: +44 (0) 7803 886248
Notes to editors
To download the paper:
Claim ID: dXqxsBAtdBDSsAxg
Claim Passcode: 3ZrZ5BGvKV6yXnnd
- About Imperial College Academic Health Science Centre (AHSC)
The AHSC is a partnership between Imperial College London, The Institute of Cancer Research (ICR) Imperial College Healthcare NHS Trust, Chelsea and Westminster NHS Foundation Trust and the Royal Marsden NHS Foundation Trust, based in West London.
Established in 2007, it was the first AHSC to be created in the UK and was formally designated by the Department of Health in 2009.
The partnership brings together multi-disciplinary research and education from across all faculties at the College with the resources and critical mass of the three Trusts to advance discovery and innovation within healthcare.
The purpose of Imperial College AHSC is to utilise excellence in research and education to transform health outcomes, and support the UK's globally competitive position in healthcare related industries by increasing societal and economic gain.
The AHSC is nested within Imperial College Health Partners, the Academic Health Science Network for North West London, which will ensure that discoveries and innovations are applied on a national and global scale.
2. About Imperial College London
Imperial College London is one of the world's leading universities. The College's 16,000 students and 8,000 staff are expanding the frontiers of knowledge in science, medicine, engineering and business, and translating their discoveries into benefits for society.
Founded in 1907, Imperial builds on a distinguished past - having pioneered penicillin, holography and fibre optics - to shape the future. Imperial researchers work across disciplines to improve health and wellbeing, understand the natural world, engineer novel solutions and lead the data revolution. This blend of academic excellence and its real-world application feeds into Imperial's exceptional learning environment, where students participate in research to push the limits of their degrees.
Imperial collaborates widely to achieve greater impact. It works with the NHS to improve healthcare in west London, is a leading partner in research and education within the European Union, and is the UK's number one research collaborator with China.
Imperial has nine London campuses, including its White City Campus: a research and innovation centre that is in its initial stages of development in west London. At White City, researchers, businesses and higher education partners will co-locate to create value from ideas on a global scale.
Imperial College London is a world-class university with a mission to benefit society through excellence in science, engineering, medicine and business.
3. About Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust is one of the largest hospital Trust's in England, providing acute and specialist healthcare for a population of nearly two million people. The Trust has five hospitals - Charing Cross, Hammersmith, Queen Charlotte's & Chelsea, St Mary's and The Western Eye as well as community services.
4. UCL – London’s Global University
UCL is a diverse community with the freedom to challenge and think differently.
Our community of more than 41,500 students from 150 countries and over 12,500 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.
We are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.
We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.
For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.
We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.
Find out how UCL is helping lead the global fight against COVID-19 www.ucl.ac.uk/covid-19-research
The Lancet Oncology