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Updated: Jul 3, 2026
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Is there any clinical parameter able to predict prostate cancer after initial diagnosis of atypical small acinar
Luigi Mearini1, Elisabetta Costantini, Guido Bellezza
1Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology, University of Perugia, Perugia, Italy. luigi.mearini@tin.it
Introduction:
Tissue samples from prostate biopsy may contain atypical small acinar proliferation (ASAP): present guidelines recommend a repeat biopsy policy. This study attempted to identify clinical patterns that help predict cancer detection at second biopsy.
Materials And Methods:
From 1999 to 2005, 1,274 patients underwent a prostate biopsy: in 5.9% ASAP was found, and patients underwent a second biopsy. Uni- and multivariate analysis compared the clinical patterns of cancer patients with the no cancer group at second biopsy.
Results:
Univariate analysis showed significant differences in PSA ratio density, prostate volume, final PSA values and Delta PSA; at multivariate logistic regression analysis, only PSA ratio (OR = 0.743, 95% CI 0.620-0.891) and prostate volume (OR = 0.960, 95% CI 0.924-0.998) were predictive of malignancy.
Conclusions:
In our experience, PSA ratio and prostate volume seem to be independent predictors of prostate cancer at re-biopsy.
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