Prostate Cancer Diagnostic Breakthrough: High-Resolution Micro-Ultrasound Cuts Screening Time

(Taipei, June 18 — Reporter Chen Chieh-ling) Prostate cancer is now the third most common cancer among men in Taiwan, with cases rising due to the country's rapidly aging population. However, long wait times for magnetic resonance imaging (MRI) screenings hinder early detection and diagnosis. To address this, National Taiwan University Hospital (NTUH) has introduced high-resolution micro-ultrasound (microUS), aiming to achieve diagnosis within one month and treatment within two months.

Dr. Chueh Shih-Chieh, Director of the Department of Urology at NTUH, stated at a press conference today that prostate cancer has risen from the sixth to the third most common cancer among Taiwanese men. Early detection offers most patients a chance of cure, but currently, about one-third of prostate cancer patients in Taiwan are already metastatic at diagnosis, missing the optimal window for complete recovery—a situation Dr. Chueh described as deeply regrettable.

"It's an undeniable fact that MRI scans at hospitals now require waiting periods of three to six months," said Dr. Chueh. Micro-ultrasound (microUS) is a next-generation high-resolution prostate imaging technology. Clinical trial results published in 2024 show its diagnostic performance is comparable to MRI, offering a more accessible and effective diagnostic option that could significantly improve early detection rates for prostate cancer.

From 2025 to the end of May 2026, NTUH has used microUS-guided biopsies on 324 patients. The overall diagnosis rate reached 60.7%, with clinically significant prostate cancer detected in 47.8% of cases. Dr. Chiu Shih-Ting, attending physician in the Department of Urology, emphasized that this demonstrates the critical value of microUS in precise prostate cancer diagnosis. Notably, even without MRI assistance, microUS maintains a high cancer detection rate.

Dr. Chiu explained that microUS has dramatically shortened the diagnostic pathway. In the past, after an abnormal prostate-specific antigen (PSA) blood test, patients typically waited 4–6 months for an MRI, another 1–3 weeks for biopsy scheduling, and about one week for pathology results—totaling up to seven months before diagnosis and treatment could begin.

Now, after an abnormal PSA result, patients are scheduled for microUS within about one week. Biopsy follows within 1–3 weeks, and pathology results are available in approximately one week. Once cancer is confirmed, care coordinators expedite MRI scheduling within six weeks for further treatment planning. This reduces the timeline to diagnosis in 1–2 months and treatment initiation in 2–3 months.

Dr. Chiu expressed hope for further streamlining: a "one-stop" approach where microUS imaging and immediate biopsy are performed together about one week after PSA detection. This could enable diagnosis within one month and treatment within two months, allowing patients to receive accurate diagnoses and appropriate care earlier, thereby improving the quality of prostate cancer care and treatment outcomes.

All microUS biopsies at NTUH use the transperineal approach. Among over 300 biopsy cases, postoperative sepsis has remained at 0%. Since this approach avoids the rectal route and bacterial contamination, it significantly reduces the risk of postoperative infection, sepsis, and hospital readmission compared to the traditional transrectal method.

However, Dr. Chiu noted limitations: because ultrasound scans are conducted via the rectum, lesions at the anterior prostate—farther from the probe—may be missed. Prostate enlargement or calcification can also affect image clarity. Therefore, ultrasound has inherent limitations, and MRI may still be necessary for further evaluation when needed. (Edited by Chen Ching-Fang) 1150618