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The review evaluates emerging imaging options when mpMRI is unavailable, including advanced transrectal ultrasound techniques (elastography, contrast-enhanced ultrasound, improved B-mode and Doppler) and their combination into multiparametric ultrasound (mpUS). It also summarizes micro-ultrasound and PSMA PET/CT performance for detecting primary lesions aligned with tumor aggressiveness, and discusses how artificial intelligence may reshape radiology and pathology practice, including future AI-enabled applications in imaging and histology.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/advances-in-radiology-and-pathology-of-prostate-cancer-a-review-for-the-pathologist/331923/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/advances-in-radiology-and-pathology-of-prostate-cancer-a-review-for-the-pathologist/331923.png","ImageObject",300,407,{"name":92,"@type":93},"Finn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is systematic biopsy still recommended when mpMRI is available?","Question",{"text":113,"@type":114},"Systematic biopsy is recommended to reduce the 15–20% false negative rate of mpMRI, even though MRI-targeted biopsy accuracy is supported by level one evidence.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What ultrasound advances are discussed as alternatives or complements to traditional TRUS?",{"text":118,"@type":114},"The review highlights elastography, contrast-enhanced ultrasound, and improved B-mode and Doppler techniques, which can be combined as multiparametric ultrasound (mpUS).",{"name":120,"@type":111,"acceptedAnswer":121},"How do PSMA PET/CT and micro-ultrasound contribute to prostate cancer detection?",{"text":122,"@type":114},"PSMA PET/CT is described as sensitive for detecting primary prostatic lesions, with uptake correlated to tumor aggressiveness; micro-ultrasound is presented as a promising imaging technology for PCa diagnosis.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},331923,1790059570,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":105,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41},34359740700684,"https://ap-avatar.wpscdn.com/avatar/1f400023980c374ae676?_k=1777273430885731487","PATHOLOGICA 2024;116:1-12; DOI: 10.32074/1591-951X-925  \nReceived: September 29, 2023  \nAccepted: October 9, 2023  \nPublished online: February 8, 2024  \nCorrespondence  \nPietro Pepe  \nE-mail: [piepepe@hotmail.com](piepepe@hotmail.com)  \nHow to cite this article: Pepe P, Fandella A, Barbera B, et al. Advances in radiology and pathology of prostate cancer: a review for the pathologist. Pathologica 2024;116:1-12 . [https://doi.org/10.32074/1591-951X-925](https://doi.org/10.32074/1591-951X-925)  \n© Copyright by Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology  \n OPEN ACCESS  \nThis is an open access journal distributed in accordance with the CC-BY-NC-ND (Creative Commons AttributionNonCommercial-NoDerivatives 4.0 International) license: the work can be used by mentioning the author and the license, but only for non-commercial purposes and only in the original version. For further information: [https://creativecommons](https://creativecommons). org/licenses/by-nc-nd/4.0/deed.en  \nReview  \nAdvances in radiology and pathology of prostate cancer: a review for the pathologist  \nPietro Pepe1 , Andrea Fandella2 , Michele Barbera3 , Pasquale Martino4 , Francesco Merolla5 , Alessandro Caputo6 , Filippo Fraggetta7  \n1 Urology Unit, Cannizzaro Hospital, Catania, Italy; 2 Urology Unit, Casa di Cura Rizzola San Donà di Piave (VE), Italy; 3 Urology Unit, Giovanni Paolo II Hospital, Sciacca, Italy;4 Urology Unit, Santa Maria Hospital-GVM, Bari, Italy; 5 Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy;  \n6 Pathology Unit, Ruggi University Hospital, Salerno, Italy; 7 Pathology Unit, Gravina Hospital, Caltagirone (CT), Italy  \nSummary  \nMultiparametric magnetic resonance imaging (mpMRI) has improved systematic prostate biopsy procedures in the diagnosis of clinically significant prostate cancer (csPCa) by reducing the number of unnecessary biopsies; numerous level one evidence studies have confirmed the accuracy of MRI-targeted biopsy, but, still today, systematic prostate biopsy is recommended to reduce the 15-20% false negative rate of mpMRI. New advanced imaging has been proposed to detect suspicious lesions and perform targeted biopsies especially when mpMRI cannot be performed. Transrectal ultrasound (TRUS) modalities are emerging as methods with greater sensitivity and specificity for the detection of PCa compared to the traditional TRUS; these techniques include elastography and contrastenhanced ultrasound, as well as improved B-mode and Doppler techniques. These modalities can be combined to define a novel ultrasound approach: multiparametric ultrasound (mpUS) . More recently, micro-ultrasound (MicroUS) and prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) have demonstrated to be sensitive for the detection of primary prostatic lesions resulting highly correlated with the aggressiveness of the primary prostatic tumor. In parallel, artificial intelligence is advancing and is set out to deeply change both radiology and pathology. In this study we address the role, advantages and shortcomings of novel imaging techniques for Pca, and discuss future directions including the applications of artificial intelligence–based techniques to imaging as well as histology. The significance of these findings for the practicing pathologist is discussed.  \nKey words: prostate cancer, fusion prostate biopsy, mpMRI, PSMA PET/CT, artificial intelligence  \nIntroduction  \nScreening 1 and case-finding protocols 2 for prostate cancer (PCa) diagnosis are based on PSA and digital-rectal examination 3 but the risk of overdiagnosis is estimated in about 50% of cases, and thus the main goal is to detect only clinically significant PCa (csPCa) (ISUP grade group > 2); in this respect, active surveillance has become an alternative to radical treatment of low/very low risk PCa, reducing the risk of o","cbCairPujYJDfLyq","https://ap.wps.com/l/cbCairPujYJDfLyq","pdf",3330405,"English","# Summary\n# Introduction\n## Screening and risk stratification\n## mpMRI and biopsy strategies\n## Emerging ultrasound modalities\n## Micro-ultrasound and PSMA PET/CT","[{\"question\":\"Why is systematic biopsy still recommended when mpMRI is available?\",\"answer\":\"Systematic biopsy is recommended to reduce the 15–20% false negative rate of mpMRI, even though MRI-targeted biopsy accuracy is supported by level one evidence.\"},{\"question\":\"What ultrasound advances are discussed as alternatives or complements to traditional TRUS?\",\"answer\":\"The review highlights elastography, contrast-enhanced ultrasound, and improved B-mode and Doppler techniques, which can be combined as multiparametric ultrasound (mpUS).\"},{\"question\":\"How do PSMA PET/CT and micro-ultrasound contribute to prostate cancer detection?\",\"answer\":\"PSMA PET/CT is described as sensitive for detecting primary prostatic lesions, with uptake correlated to tumor aggressiveness; micro-ultrasound is presented as a promising imaging technology for PCa diagnosis.\"}]","Advances in radiology and pathology of prostate cancer - a review for the pathologist | PDF",1789995770]