This work aims to evaluate the detection rate of magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided biopsy for clinically significant prostate cancers (Cs PCas), with a particular interest in biopsy-naive patients and patients in active surveillance. MRI-targeted biopsy improves cancer detection rate (DR) in patients with prior negative biopsies; the current literature focuses on biopsy naive patients. We also evaluated the pathologic concordance between biopsies and surgical specimens.

MRI/TRUS fusion-guided biopsies were performed between February 2016 and February 2019. Patients with previous negative biopsies, biopsy-naive, or active surveillance (AS) were included. Cs PCas were defined through Epstein’s criteria.

A total of 416 men were enrolled. In patients who underwent radical prostatectomy (RP), the concordance between biopsy GS (bGS) and pathological GS (pGS) was 90.8%.

Our study highlights the role of MRI/TRUS fusion prostate biopsy in detecting PCa in patients with previous negative biopsies focusing on Cs PCa diagnosis. The MRI/TRUS fusion biopsy is also emerging as a diagnostic tool in biopsy-naïve patients and deserves a fundamental role in AS protocols. A more excellent concordance between bGS and pGS can be achieved with targeted biopsies.

Reference: https://journals.sagepub.com/doi/full/10.1177/1756287220916613

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