Abstract
Aim:
Targeted prostate biopsies using magnetic resonance imaging (MRI) have gained prominence for early detection. We compared cognitive fusion biopsy, the most practical of these biopsy methods, with systematic prostate biopsy performed under transrectal ultrasonography (TRUS).
Methods:
Between August 2021 and August 2022, 81 patients who had never undergone prostate biopsy or surgery, with total prostate-specific antigen (PSA) levels between 4 and 20 ng/mL, and had lesions scoring 3 or above on the Prostate Imaging Reporting and Data System (PIRADS) on multiparametric MRI (Mp-MRI), were included in the study. Of these patients, 39 underwent standard TRUS-guided systematic prostate biopsy, while 42 underwent cognitive fusion biopsy (systematic + targeted).
Results:
The ages, PSA levels, and prostate volumes of the patients included in the study were compared, and no significant differences were found between the groups. The prostate cancer detection rate was 41% in the systematic biopsy group and 52.4% in the cognitive fusion biopsy group, but this difference was not statistically significant (p = 0.306). The detection rate of clinically significant prostate cancer was 25% in the systematic biopsy group and 63.6% in the cognitive fusion biopsy group, with this difference being statistically significant (p = 0.019). In the cognitive fusion biopsy group, 36.4% of patients with malignant biopsy results had no tumour at the targeted site, while 63.6% had tumours detected at the targeted site (p = 0.286).
Conclusion:
Cognitive fusion biopsy was found to be superior to standard TRUS-guided systematic prostate biopsy in diagnosing clinically significant prostate cancer. However, there was no difference between the two biopsy techniques in overall prostate cancer detection.
Level of evidence:
Not applicable
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