# Is Standard TRUS-Guided Prostate Biopsy the End of the Game?

## TL;DR

This study compares the effectiveness and cost of standard TRUS-guided prostate biopsy with MRI-targeted biopsy for prostate cancer diagnosis.

## Contribution

The study provides a cost comparison and clinical outcomes analysis of TRUS-guided versus MRI-targeted prostate biopsies.

## Key findings

- TRUS-guided biopsy detected prostate cancer in 40.3% of patients.
- MRI-targeted biopsy was significantly more expensive (US $1449) compared to TRUS-guided biopsy (US $26.8).
- TRUS-guided biopsy remains cost-efficient and effective where MRI access is limited.

## Abstract

Prostate cancer (PCa) remains a major cause of morbidity and mortality among men worldwide, and histopathologic tissue sampling plays a pivotal role in diagnosis. Although transrectal ultrasound–guided prostate needle biopsy (TRUS biopsy) has been the standard diagnostic technique for decades, its effectiveness has increasingly been questioned with the widespread adoption of cognitive and magnetic resonance imaging (MRI)–targeted biopsy techniques. The aim of this study was to present the clinical outcomes and costs of TRUS-guided prostate biopsy performed in the clinic and to compare its costs with those of MRI-targeted biopsy.

Data from 221 patients who underwent prostate biopsy were retrospectively analyzed. Patient comorbidities, prostate-specific antigen levels, digital rectal examination findings, histopathologic results, and biopsy-related costs were recorded. Cost data for MRI-targeted biopsy were obtained from 9 private hospitals located in different regions of the country.

Prostate cancer was detected in 40.3% (n = 89) of the 221 patients. Clinically significant PCa was identified in 29.9% (n = 66), whereas malignancy could not be excluded in 1.4% (n = 3). The mean cost of TRUS-guided prostate biopsy performed in the clinic was calculated as US $26.8. In contrast, based on data obtained from 9 hospitals, the reported mean cost of MRI-targeted biopsy was US $1449.

Transrectal ultrasound–guided prostate needle biopsy remains an effective and highly cost-efficient diagnostic method in patients with suspected PCa. This technique may be particularly valuable in clinical settings where access to MRI-targeted biopsy is limited.