多参数磁共振成像（mpMRI）在前列腺癌的检测方面提供了增强的诊断准确性，但并非没有局限性。鉴于非磁共振成像技术的最新发展，本文的批判性文献综述旨在总结有关基于超声和核医学成像技术的初步诊断前列腺癌的可用证据。通过PubMed®，Web of Science™和Scopus®三个数据库来查询对其在基于组织学诊断前列腺癌的初步诊断中的诊断性能进行研究的文献，其中采用自由文本协议。纳入回顾性和前瞻性研究，两者均为比较性和非比较性研究，系统综述（SR）和荟萃分析（MA）。根据作者的专家意见，选择研究，提取数据，并将结果进行定性描述。 微型超声（micro-US）作为一种有吸引力的诊断策略，由于其检测前列腺癌的高准确性，表面上不逊于mpMRI。多参数超声（mpUS）的使用可能在效果上具有优势，因为它结合了不同的模式，尤其是当结合某些模式时更具优势。前列腺特异性膜抗原（PSMA）PET/CT可能代表了一个全身一步的适当诊断和分期前列腺癌的方法。肿瘤追踪剂对病灶亲和性与组织病理学和预后特征之间的直接关系以及其有效的诊断表现具有吸引人的特点。然而，这些技术各自固有的限制存在，并且在最终将它们视为准确诊断前列腺癌的可靠工具之前，需要进一步的研究。其他新技术，如弹性成像和多参数超声，目前仅依靠有限的研究，因此关于它们的证据仍然是初步的。 非磁共振成像选项在初步诊断前列腺癌方面的作用的证据正在稳步增强。这证明了对新技术的不断兴趣，这些技术可能有助于克服当前金标准磁共振成像的一些局限性。 © 2023年。作者（们），在Springer Nature Limited独家许可下。

Multiparametric magnetic resonance imaging (mpMRI) provides enhanced diagnostic accuracy in the detection of prostate cancer, but is not devoid of limitations. Given the recent evolution of non-MRI imaging techniques, this critical review of the literature aimed at summarizing the available evidence on ultrasound-based and nuclear medicine imaging technologies in the initial diagnosis of PCa.Three databases (PubMed®, Web of Science™, and Scopus®) were queried for studies examining their diagnostic performance in the primary diagnosis of PCa, weighted against a histological confirmation of PCa diagnosis, using a free-text protocol. Retrospective and prospective studies, both comparative and non-comparative, systematic reviews (SR) and meta-analysis (MA) were included. Based on authors' expert opinion, studies were selected, data extracted, and results qualitatively described.Micro-ultrasound (micro-US) appears as an appealing diagnostic strategy given its high accuracy in detection of PCa, apparently non-inferior to mpMRI. The use of multiparametric US (mpUS) likely gives an advantage in terms of effectiveness coming from the combination of different modalities, especially when certain modalities are combined. Prostate-specific membrane antigen (PSMA) PET/CT may represent a whole-body, one-step approach for appropriate diagnosis and staging of PCa. The direct relationship between lesions avidity of radiotracers and histopathologic and prognostic features, and its valid diagnostic performance represents appealing characteristics. However, intrinsic limits of each of these techniques exist and further research is needed before definitively considering them reliable tools for accurate PCa diagnosis. Other novel technologies, such as elastography and multiparametric US, currently relies on a limited number of studies, and therefore evidence about them remains preliminary.Evidence on the role of non-MRI imaging options in the primary diagnosis of PCa is steadily building up. This testifies a growing interest towards novel technologies that might allow overcoming some of the limitations of current gold standard MRI imaging.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.