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Area of Science:

  • Urology
  • Radiology
  • Oncology

Background:

  • Elevated prostate-specific antigen (PSA) levels necessitate accurate prostate cancer diagnosis.
  • Multiparametric MRI (mpMRI) demonstrates high sensitivity for clinically significant prostate cancer.
  • Ultrasound (US) provides real-time guidance for prostate biopsy.

Purpose of the Study:

  • To evaluate the efficacy of MRI-ultrasound fusion targeted biopsy for prostate cancer detection.
  • To compare the performance of fusion biopsy with traditional methods and in-bore MRI biopsy.

Main Methods:

  • Utilized MRI-ultrasound image fusion for targeted prostate biopsy in patients with elevated PSA.
  • Employed various fusion techniques: cognitive, mechanical (articulated arm, electromagnetic registration), and software registration.
  • Included both transperineal and transrectal biopsy approaches.

Main Results:

  • MRI-ultrasound fusion biopsy improves detection rates of clinically significant prostate cancer.
  • This technique may reduce the detection of indolent (less aggressive) prostate cancer.
  • Fusion biopsy performance is comparable to in-bore MRI-guided biopsy.

Conclusions:

  • MRI-ultrasound fusion targeted biopsy is a recommended approach for diagnosing prostate cancer with elevated PSA.
  • The technique leverages MRI's sensitivity and ultrasound's real-time guidance for improved accuracy.
  • Factors like MRI quality, fusion method, and practitioner experience influence outcomes, with future AI integration promising further refinement.