Comparative Effectiveness of Targeted Prostate Biopsy Using Magnetic Resonance Imaging Ultrasound Fusion Software and...

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Prostate cancer diagnosis relies on accurate biopsy targeting.
• Multiparametric magnetic resonance imaging (mpMRI) identifies suspicious regions.
• Comparing biopsy techniques is crucial for optimizing diagnostic yield.

Purpose of the Study:

• To compare diagnostic outcomes of MRI-ultrasound fusion biopsy versus visually targeted biopsy for prostate cancer.
• To evaluate cancer detection rates for high-grade and any-grade prostate cancer.
• To assess the performance of each technique in different prostate zones and locations.

Main Methods:

• Prospective study comparing MRI-ultrasound fusion and visually targeted prostate biopsies.
• Two visually targeted cores and two fusion-guided cores per region of interest.
• McNemar's test for primary endpoint (cancer detection); logistic regression and Wilcoxon signed rank test for secondary endpoints.

Main Results:

• No significant difference in high-grade or any-grade cancer detection between the two methods.
• MRI-ultrasound fusion detected 15% more cancers in the transition zone (p=0.046).
• Visually targeted biopsy detected 11% more high-grade cancers at the prostate base (p=0.005).
• Only 52% of high-grade cancers were detected by both techniques, indicating complementary findings.

Conclusions:

• Neither MRI-ultrasound fusion nor visually targeted biopsy alone significantly outperformed the other in overall cancer detection.
• Technique performance varied by biopsy location, suggesting complementary roles.
• Combining both visually targeted and MRI-ultrasound fusion biopsy approaches may enhance prostate cancer detection rates.