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Updated: Feb 8, 2026

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
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Defining the target prior to prostate fusion biopsy: the effect of MRI reporting on cancer detection

Niklas Westhoff1, Fabian Siegel2, Christian Peter2

  • 1Department of Urology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. niklas.westhoff@medma.uni-heidelberg.de.

World Journal of Urology
|July 4, 2018
PubMed
Abstract

Insights

Accurate multiparametric MRI (mpMRI) target definition by radiologists and urologists is essential for precise prostate cancer detection via MRI/TRUS fusion biopsy. Improved target matching significantly predicts cancer detection, highlighting the need for optimized reporting.

Area of Science:

  • Urology
  • Radiology
  • Oncology

Background:

  • Accurate target definition in multiparametric MRI (mpMRI) is critical for effective MRI/TRUS fusion prostate biopsy.
  • Variations in target identification between urologists and radiologists can impact cancer detection rates.

Purpose of the Study:

  • To evaluate the impact of MRI reporting on target definition and cancer detection in prostate biopsies.
  • To analyze interobserver variability in target identification between urologists and radiologists.

Main Methods:

  • 202 patients underwent MRI/TRUS fusion biopsy using Artemis™ software.
  • Urologists marked targets based on written mpMRI reports; an expert uroradiologist reviewed targets independently.
  • Interobserver variability, target volumes, and cancer detection rates were analyzed using statistical models.

Main Results:

  • Moderate variability in target number and low variability in localization were observed.
  • Urologists significantly overestimated target volumes compared to radiologists (43.9% volume match).
  • Higher target volume match was a significant predictor of cancer detection (p<0.001); prostate volume and PI-RADS score were independent predictors.

Conclusions:

  • High concordance in target definition between radiologists and urologists is mandatory for accurate targeted biopsies (TB).
  • Optimized region of interest (ROI) definition, preferably radiologist contouring or precise illustrated MRI reports, is recommended.
  • High prostate volume and low PI-RADS scores can limit target definition accuracy.
Keywords:
BiopsyFusionInterobserver variabilityMultiparametric MRIProstatic neoplasms

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