Combination of fusion guided multiparametric MRI—transrectal US with systematic biopsy of the prostate for the detection of clinically significant prostate cancer: A prospective single‐center study

Abstract

AbstractPurposeTo investigate the diagnostic efficacy of fusion guided multiparametric MRI (mpMRI)—transrectal ultrasound (TRUS) biopsy versus systematic biopsy of the prostate in patients with suspicion of prostate cancer.MethodsA total of 185 patients with PI‐RADS 3 lesions or higher underwent fusion guided targeted and systematic prostate biopsy. Histology of samples was correlated with PI‐RADS score and biopsy method for each patient.ResultsA total of 81/185 (43.8%) cases positive for cancer were detected; 23/81 (28.4%) cases with clinically insignificant prostate cancer—insPCa and 58/81 (71.6%) cases with clinically significant prostate cancer—csPCa. There was a statistically significant difference in the overall detection of adenocarcinomas between methods (p = .035, McNemar test). Moreover, there was a statistically significant difference in the detection of insPCa between the two methods (p = .004, McNemar test). Systematic biopsy detected 13 patients with insPCa more (14.4%) than the targeted biopsy method. However, there is no statistical difference in the detection rate of csPCa between the two methods (p = 1, McNemar test). When both techniques were combined more cases of csPCa were detected.ConclusionThe combined implementation of fusion‐guided targeted mpMRI–TRUS and systematic biopsy of the prostate provides higher detection number of csPCa, compared to each method alone. The potential of fusion‐guided mpMRI‐TRUS biopsy of the prostate needs to be further assessed since each method has its limitations; therefore, systematic prostate biopsy still plays an important role in clinical practice.