Purpose of review: A summary and analysis of the current evidence on the role of multiparametric ultrasound in the diagnosis of clinically significant prostate cancer.
Recent findings: Earlier work on brightness-mode or Doppler ultrasound did not reveal an adequate diagnostic performance but the addition of contrast-enhanced ultrasound and elastography shows greater promise. There has been an increase in trials on contrast-enhanced ultrasound of late, with and without the use of quantification, such as parametric mapping of contrast uptake. Shear wave elastography offers quantification for this modality also and early work is available on the kilopascal thresholds that may be significant for malignancy. Perhaps the most promising avenue is the combination of the above modalities but to date only one study has considered this.
Summary: Although there is a paucity of high-quality studies at present, particularly those that combine all the available ultrasound modalities, the performance of ultrasound is seen to approach that of multiparametric MRI in some cases. More work is needed to define a role, if any, for ultrasound in the diagnosis of prostate cancer.