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Advances in Prostate Biopsy.

Jillian M Egan Kelly1, Badar M Mian1

  • 1Department of Urology, Albany Medical Center, Albany, NY 12208, USA.

The Urologic Clinics of North America
|November 20, 2025
PubMed
Summary
This summary is machine-generated.

Prostate biopsy techniques have improved for better cancer detection and safety. Recent trials show transrectal and transperineal biopsies have similar outcomes, with future advancements expected.

Keywords:
Biopsy templatesCancer detectionComplicationsHigh-resolution ultrasound transrectalProstate MRIProstate biopsyTransperineal

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Area of Science:

  • Urology
  • Oncology
  • Medical Imaging

Background:

  • The ultrasound-guided, transrectal, sextant prostate biopsy has evolved significantly.
  • Biopsy template modifications, from 6 to 24 samples, with 10-12 cores being most effective, have improved diagnostic yield.
  • Multi-parametric magnetic resonance imaging (mpMRI) aids in managing prostate cancer overdiagnosis concerns.

Purpose of the Study:

  • To review modifications in prostate biopsy procedures.
  • To evaluate the diagnostic yield and safety of evolving biopsy techniques.
  • To compare the efficacy and safety of transrectal versus transperineal prostate biopsy.

Main Methods:

  • Review of modifications in ultrasound-guided, transrectal, sextant prostate biopsy.
  • Analysis of biopsy template evolution and effectiveness.
  • Inclusion of multi-parametric magnetic resonance imaging (mpMRI) in diagnostic strategies.
  • Consideration of evidence from three large randomized trials comparing transrectal and transperineal biopsy approaches.

Main Results:

  • The 10-12 core biopsy template is considered most effective.
  • Multi-parametric MRI helps address overdiagnosis of low-risk prostate cancer.
  • Three large randomized trials indicate similar efficacy and safety outcomes for transrectal and transperineal prostate biopsies.

Conclusions:

  • Prostate biopsy procedures have been refined to enhance diagnostic accuracy and patient safety.
  • Transrectal and transperineal biopsy methods demonstrate comparable results.
  • Future advancements in biomarkers and molecular imaging promise further improvements in prostate biopsy efficacy and safety.