Magnetic Resonance Imaging–Transrectal Ultrasound Fusion‐Targeted Biopsy Improves the Diagnostic Efficacy of Overall and Clinically Significant Prostate Cancer

TL;DR

MRI-TRUS fusion-targeted biopsy detects more clinically significant prostate cancer than traditional methods without increasing risks.

Contribution

Demonstrates improved diagnostic efficacy of MRI-TRUS fusion biopsy over conventional methods in prostate cancer detection.

Findings

MRI-TRUS fusion biopsy detected 66% overall prostate cancer vs. 49% with conventional methods.

It detected 58% clinically significant prostate cancer vs. 41% with conventional methods.

Adverse event rates were similar between MRI-TRUS and conventional biopsy groups.

Abstract

As the diagnostic efficacy and safety of magnetic resonance imaging (MRI)–transrectal ultrasound (TRUS) fusion‐targeted transrectal biopsy for prostate cancer (PCa) detection have already been demonstrated when compared with those of conventional systematic biopsy, we aimed to further evaluate them.

In this retrospective study, we included patients who underwent MRI–TRUS fusion‐targeted transrectal biopsy combined with systematic biopsy between 2022 and 2024. The detection rates for overall and clinically significant PCa and adverse event (≥ grade 3) rates were assessed. The results were compared with those of conventional systematic biopsies using propensity score matching.

In 223 patients who underwent MRI–TRUS fusion biopsy combined with systematic biopsy (initial biopsy, 161; repeat biopsy, 62), the median prostate‐specific antigen level was 8.0 ng/mL; the median prostate volume was 35 mL. The overall, clinically significant, and insignificant PCa detection rates were 67%, 60%, and 8%, respectively. After propensity score matching, detection rates were significantly higher in the MRI–TRUS fusion group than in the control group for overall PCa (66% vs. 49%, p = 0.005) and clinically significant PCa (58% vs. 41%, p = 0.005), but were not significantly different for clinically insignificant PCa (8% vs. 8%, p = 1.000). The adverse event rate (≥ grade 3) was not significantly different between the groups (3% vs. 3%, p = 1.000).

Compared with conventional biopsy, MRI–TRUS fusion‐targeted transrectal biopsy combined with systematic biopsy could effectively detect clinically significant PCa without increasing detection of clinically insignificant PCa and adverse event rates.