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Updated: May 10, 2025
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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
106
Enhancing Prostate Cancer Diagnosis: A Comparative Analysis of Combined Fusion and Systematic Biopsy Methods-A
Emil Kania1, Maciej Janica2, Grzegorz Hrehoruk1
1Department of Urology, Śniadeckiego Voivodeship Hospital in Bialystok, 26 Sklodowskiej-Curie St., 15-278 Bialystok, Poland.
Journal of Clinical Medicine
|April 26, 2025
Summary
Combined fusion biopsy (ComBx) significantly improves prostate cancer detection, especially clinically significant cases, over traditional transrectal US-guided biopsy (TRUS-Bx). This advanced technique enhances diagnostic accuracy for prostate cancer, improving patient outcomes.
Area of Science:
- Urology
- Oncology
- Medical Imaging
Background:
- Prostate cancer is a leading global malignancy in men.
- Diagnosis often relies on digital rectal examination (DRE) and PSA levels.
- Accurate detection of clinically significant prostate cancer (csPCa) is crucial.
Purpose of the Study:
- To compare the effectiveness of transperineal combined fusion biopsy (ComBx) versus transrectal US-guided biopsy (TRUS-Bx).
- To evaluate the detection rates of overall prostate cancer (PCa) and csPCa (ISUP grade ≥ 2).
Main Methods:
- Retrospective cohort study of 500 men (2017-2022).
- Two groups: 250 with TRUS-Bx (12-core) and 250 with ComBx (MRI-guided, targeted PI-RADS ≥ 3 + systematic samples).
- Comparison of PCa and csPCa detection rates between techniques.
Main Results:
- ComBx showed higher overall PCa detection (ISUP ≥ 1): 61% vs. 45% (p < 0.001).
- ComBx demonstrated superior csPCa detection: 40% vs. 30% (p = 0.019).
- For ComBx, csPCa detection rates for PI-RADS 3, 4, and 5 lesions were 17%, 51%, and 78% respectively.
Conclusions:
- ComBx significantly outperforms TRUS-Bx in detecting prostate cancer, especially csPCa.
- ComBx enhances diagnostic accuracy for csPCa, making it a valuable tool.
- MRI-guided fusion biopsy represents an advancement in prostate cancer diagnostics.
