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Related Experiment Video

Updated: Jan 4, 2026

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
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Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance

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Are targeted prostate biopsies ready to replace systematic prostate biopsies?

A Celma1, R López1, S Roche1

  • 1Departamento de Urología, Hospital Universitario Vall d'Hebron, Barcelona, España.

Actas Urologicas Espanolas
|November 5, 2019
PubMed
Summary

Cognitive fusion prostatic biopsy (CFPB) shows higher effectiveness and efficiency in diagnosing significant prostate cancer (SPCa) compared to systematic prostatic biopsy (SPB). However, CFPB cannot yet fully replace SPB due to a missed detection rate of up to 15% for SPCa.

Keywords:
Biopsias de próstata dirigidasBiopsias dirigidas a fusión cognitivaCognitive fusion targeted biopsiesCáncer de próstataMulti-parametric MRIProstate cancerResonancia magnética multiparamétricaTargeted prostate biopsies

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Area of Science:

  • Urology
  • Oncology
  • Diagnostic Imaging

Background:

  • Prostate cancer (PCa) diagnosis relies heavily on biopsy.
  • Evaluating novel biopsy techniques is crucial for improving diagnostic accuracy and efficiency.

Purpose of the Study:

  • To compare the efficacy and efficiency of systematic prostatic biopsy (SPB) and cognitive fusion prostatic biopsy (CFPB) for diagnosing PCa and significant PCa (SPCa).
  • To assess if CFPB can safely replace SPB in clinical practice.

Main Methods:

  • A prospective study involving 314 men with PI-RADS ≥2 on 3T mp-MRI.
  • Trans-rectal ultrasound CFPB (targeting suspicious areas) and 12-core peripheral SPB were performed.
  • Significant PCa (SPCa) was defined as WHO grade >2 (Gleason 4+3 or higher).

Main Results:

  • PCa was diagnosed in 42.4% of men, with 62.4% classified as SPCa.
  • SPB detected PCa in 85.7% and SPCa in 77.1% of cases.
  • CFPB detected PCa in 77.4% and SPCa in 85.5% of cases.
  • CFPB detected SPCa exclusively in 23.5% of cases where it was missed by SPB.
  • CFPB required significantly fewer cores per diagnosis (8.5 for PCa, 12.4 for SPCa) compared to SPB (33.1 for PCa, 58.9 for SPCa).

Conclusions:

  • CFPB demonstrates superior effectiveness and efficiency in detecting significant prostate cancer (SPCa) compared to SPB.
  • Despite its advantages, CFPB is not yet a safe replacement for SPB due to its inability to detect approximately 15% of SPCa cases.