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Updated: Nov 28, 2025
06:08
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
726
Do not underestimate anterior prostate cancer
Sarka Kudlackova1, Daniela Kurfurstova2, Milan Kral1
1Department of Urology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
Summary
Anterior prostate cancer (APC) is more common than previously reported and often requires aggressive treatment. Early detection with MRI-targeted biopsy is crucial to avoid undertreatment and improve patient outcomes.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- The advent of magnetic resonance imaging (MRI) has increased the detection of anterior prostate cancer (APC).
- Anteriorly located tumors present unique diagnostic challenges compared to posterior prostate cancer (PPC).
Purpose of the Study:
- To evaluate the incidence and characteristics of anterior-predominant prostate cancer (APC).
- To compare clinicopathological outcomes between APC and PPC.
- To assess the role of preoperative MRI in APC detection.
Main Methods:
- Retrospective analysis of 200 radical prostatectomy patients (12/2017-04/2019).
- Evaluation of tumor location, index tumor volume, and postoperative outcomes (stage, Gleason score, grade group, EPE).
- Assessment of preoperative MRI use, family history, and PSA levels in relation to APC.
Main Results:
- A significantly higher incidence of anterior tumors (37%) was observed compared to previous reports.
- Anterior tumors were associated with significantly larger index tumor volumes.
- Preoperative MRI was significantly more common in patients with anterior tumors.
- Low-risk APC constituted only 6.76% of cases, indicating a high need for treatment.
Conclusions:
- The frequency of anterior prostate cancer is underestimated, and these tumors often warrant radical treatment.
- Neglecting APC can lead to undertreatment and negatively impact patient prognosis.
- MRI-targeted prostate biopsy is essential for accurate diagnosis, especially in cases of negative biopsies or before active surveillance initiation.
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