[Fusion biopsy. Analysis of fusion software platforms.]

Transrectal ultrasound has been a diagnostic method for diagnosis of prostate cancer for more than 30 years. It increased its options after the incorporation of MRI in the 90s. The association of real-time ultrasound with anatomical and functional data of multiparametric magnetic resonance imaging (mpMRI) has changed the prostate cancer scenario and presumably will modify the therapeutic alternatives.

In the following non systematic review of the literature, we present the current situation of different types of fusion biopsy, the initial preclinical and clinical results as well as the data collected in the different meta-analyses.

Although "in bore" biopsy has shown the best sensitivity, its economic and accessibility problems make it the least widespread. Cognitive biopsy is one of the most widespread despite being the one that provides the least objective results. Fusion biopsies with Software Platform are being developed as the most reproducible and affordable in our environment. The data in the literature is still insufficient to establish what is the best software. There are many points of controversy such as number of cores, approach, associated systematic biopsies and possible connotations when assessing the therapeutic attitude.

None of the Software platforms have demonstrated superiority in the diagnosis of cancer, although their results are superior to those obtained through standard and cognitive biopsy and are more affordable than the "In bore" biopsy. It is necessary to standardize the publications to be able to compare results (classification of risk in resonance, number of cores, approach). The diagnosis of cancer guided by MRI should be a factor to consider in therapeutic decision nomograms. The next challenge is the incorporation of these systems in the protocols of active surveillance and Focal Therapy.