{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:50:16Z","timestamp":1791571816404,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Prostate Cancer Prostatic Dis"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Prostate cancer (PCa) screening is increasingly guided by imaging. High-resolution 29\u2009MHz Micro-Ultrasound (MUS) offers a promising alternative to magnetic resonance imaging (MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 682 consecutive men undergoing MUS and PSA testing during routine examination. Biopsy and MRI were performed according to guideline recommendations. PSA density (PSAD)-modified negative MUS included PRI-MUS categories 1, 2, or 3 with PSAD\u2009&lt;\u20090.15\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      ; PSAD-modified positive MUS included PRI-MUS categories 3 with PSAD\u2009\u2265\u20090.15\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      , 4 or 5.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age was 59 years; median PSA 1.2\u2009ng\/mL (IQR: 0.6\u20133.5). Biopsies were performed in 62 men, detecting PCa in 29 (47%), including 18 (29%) clinically significant PCa (csPCa). 88 men (13%) had PSAD-modified positive MUS, yielding 15 csPCa and 7 non-clinically significant PCa (ncsPCa). Among 594 men (87%) with PSAD-modified negative MUS, 3 csPCa and 4 ncsPCa were detected. Compared to PSA-based biopsy indication \u22653\u2009ng\/mL, PSAD-modified negative MUS would have avoided 13 negative, missing two csPCa and four ncsPCa.<\/jats:p>\n                    <jats:p>\n                      Compared to the MRI-based biopsy indication (PI-RADS\u2009\u2265\u20093,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200938), PSAD-modified negative MUS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009594) would have spared 3 negative biopsies, as well as 17 (24.7% of 69) MRIs due to negative biopsy, while missing 0 cases of csPCa.\n                    <\/jats:p>\n                    <jats:p>Additionally, MRI could have been omitted in 1csPCa case and 9 ncsPCa cases with positive MUS, and in 13 csPCa and 7 ncsPCa cases based on PSAD-modified positive MUS.<\/jats:p>\n                    <jats:p>The PSAD-modified-PRI-MUS-based screening pathway showed a 6.29-fold (OR\u2009=\u20090.16) reduction in overdiagnosis and 7.22-fold (OR\u2009=\u20090.14) reduction in negative biopsies\/ncsPCa. MUS without PSA demonstrated an OR of 7.30 to detect csPCa. PSAD-modified-PRI-MUS score demonstrated a sensitivity of 83.3%, a specificity of 59.1%, a positive predictive value of 45.5% and a negative predictive value of 89.7% for distinguishing csPCa from benign\/ncsPCa findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MUS enables effective PCa risk stratification in an opportunistic screening setting supporting prospective trial development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>This study is part of the PROSTAMUS trial, registered in the DRKS\/WHO registry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41391-026-01075-x","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T09:13:58Z","timestamp":1769418838000},"page":"799-805","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The value of micro-ultrasound for prostate cancer screening: A retrospective real-world feasibility study"],"prefix":"10.1038","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2666-6348","authenticated-orcid":false,"given":"Johann Jakob","family":"Wendler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Bechstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Buckendahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Kruck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Samtleben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd Uwe","family":"Liehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Porsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-5633","authenticated-orcid":false,"given":"Hannes","family":"Cash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"1075_CR1","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.eururo.2019.02.009","volume":"76","author":"J Hugosson","year":"2019","unstructured":"Hugosson J, Roobol MJ, M\u00e5nsson M, Tammela TLJ, Zappa M, Nelen V, et al. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. Eur Urol. 2019;76:43\u201351.","journal-title":"Eur Urol"},{"key":"1075_CR2","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1056\/NEJMoa2406050","volume":"391","author":"J Hugosson","year":"2024","unstructured":"Hugosson J, Godtman RA, Wallstrom J, Axcrona U, Bergh A, Egevad L, et al. Results after Four Years of Screening for Prostate Cancer with PSA and MRI. N Engl J Med. 2024;391:1083\u201395.","journal-title":"N Engl J Med"},{"key":"1075_CR3","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.eururo.2023.09.027","volume":"85","author":"M Boschheidgen","year":"2024","unstructured":"Boschheidgen M, Albers P, Schlemmer H-P, Hellms S, Bonekamp D, Sauter A, et al. Multiparametric Magnetic Resonance Imaging in Prostate Cancer Screening at the Age of 45 Years: Results from the First Screening Round of the PROBASE Trial. 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All other authors declare no conflict of interest.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The trial was approved by the Ethics Committee of the University of Magdeburg (vote ID: UMM 61\/25) and conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Ethics"}}]}}