# Magnetic resonance imaging/ultrasound fusion-guided transperineal prostate biopsy: Protocol for a clinic-based surgical technique

## TL;DR

This paper introduces a new protocol for prostate biopsy using MRI and ultrasound fusion to improve cancer detection and reduce infection risks.

## Contribution

A structured protocol for MRI/US fusion-guided transperineal biopsy is proposed to enhance prostate cancer diagnosis.

## Key findings

- The protocol improves detection rates of clinically significant prostate cancer.
- It reduces infection risks compared to traditional TRUS-guided methods.
- Combining targeted and systematic biopsies enhances diagnostic accuracy.

## Abstract

Prostate biopsy is a crucial diagnostic tool for detecting clinically significant prostate cancer (csPCa). Traditional transrectal ultrasound (TRUS)-guided biopsy methods are often associated with an increased infection risk of infection and limited accuracy, particularly when diagnosing anterior lesions of the prostate gland.

This article presented a structured protocol for performing transperineal fusion magnetic resonance imaging/ultrasound (MRI/US) prostate biopsy, highlighting its advantages over the TRUS approach. Our study included biopsy-naïve patients with elevated prostate-specific antigen levels or abnormal digital rectal examination findings, all of whom underwent pre-biopsy multiparametric MRI to guide targeted biopsies. The key objectives of this protocol were to improve the detection rates of csPCa, minimize infection risk, and standardize a transperineal technique that combines both systematic and targeted biopsies. In addition, we provided details on patient preparation, equipment requirements, procedural steps, and follow-up protocols to ensure the safety and effectiveness of the procedure. This protocol aims to serve as a guideline for institutions to adopt MRI/US fusion-guided transperineal biopsy, thereby enhancing diagnostic accuracy and patient safety.

The transperineal fusion MRI/US biopsy protocol enhances diagnostic accuracy, particularly for anterior lesions, while reducing infections risks. Combining targeted and systematic biopsies improves detection rates of csPCa and offers a standardized, safe approach for clinical implementation.