Magnetic Resonance Imaging/Transrectal Ultrasound (MRI/TRUS) Fusion-Guided Prostate Biopsy: A Single-Center...

The role of magnetic resonance imaging (MRI) targeted biopsy has increased in the diagnostic pathway of prostate cancer. The objective of this study was to describe our experience with MRI/transrectal ultrasound (MRI/TRUS) fusion-guided prostate biopsy in a regional hospital, with an emphasis on the technique of the procedure.  Methods: This was a single-center, retrospective study. Cases of MRI/TRUS fusion-guided prostate biopsy performed in Pamela Youde Nethersole Eastern Hospital, Hong Kong, from September 2022 to December 2024 were reviewed. Systematic biopsy was also performed for all cases. Data were retrieved from electronic medical records. Procedural-related technical factors, fusion success rate, complications, and histopathological results were reviewed.

A total of 125 patients were included in the study, with successful MRI/TRUS fusion performed in 124 patients (99.2%). The median number of passes to each targeted lesion was three (range: two to five). A total of 29 targeted prostate lesions (12.2%, among 28 patients) showed adenocarcinoma. An additional 11 cases of adenocarcinoma were detected in the systematic biopsy cores. The overall per-patient prostate cancer detection rate was 31% (39/124). Post-biopsy complications were observed in 19 patients (15.3%), with acute retention of urine being the most common complication (n=10, 8.1%).

MRI/TRUS fusion-guided prostate biopsy is a feasible and safe procedure. Our experience with the procedure, including peri-procedure assessment, fusion technique, and biopsy technique, was described in detail. A combination of systematic and MRI/TRUS fusion-guided targeted biopsies of the prostate is recommended as part of the diagnostic pathway in prostate cancer.