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Updated: Mar 18, 2026
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Association of Prostate Multiparametric MRI Parameters with Gleason Score: A Fusion Biopsy-Based Correlation
Davut Ünsal Çapkan1, Mehmet Hamdi Şahan2
1Department of Radiology, Gaziantep Private Medicalpoint Hospital, Gaziantep, Turkiye.
Introduction:
This study aimed to investigate the relationship between imaging parameters obtained from Multiparametric Magnetic Resonance İmaging (MPMRI) and Gleason Scores (GS) derived from targeted prostate biopsies performed using MRI/Ultrasound (US) fusion guidance.
Materials And Methods:
A total of 120 consecutive patients who underwent 1.5T MP-MRI followed by MRI/US fusion-guided prostate biopsy were included. In total, 202 MRI-identified targets were sampled. For each lesion, anatomical location, Prostate-Specific Antigen (PSA), prostate volume, Prostate Density (PD), apparent diffusion Coefficient (ADC) values, neurovascular bundle invasion, and PI-RADS v2.1 score were recorded. GS results were statistically compared with imaging and clinical parameters. Pearson’s correlation was calculated to investigate the associations, and the diagnostic ability of ADC values was evaluated by Receiver Operating Characteristic (ROC) analysis.
Results:
Of the 202 targets, 138 (68.3%) were benign, 35 (17.3%) had GS 3+4 (low-grade), and 29 (14.4%) had GS ≥4+3 (high-grade) malignancy. ADC values were negatively correlated with age, PSA, PD, and PI-RADS score. Most lesions were located in the peripheral zone, particularly in the mid-gland and apical regions. Malignant lesions were frequently found in the peripheral zone and right mid-gland. ADC values showed strong diagnostic performance, with cut-offs of 0.78 ×10−3 mm2/s for low-grade (sensitivity: 79.69%, specificity: 86.21%) and 0.70 ×10−3mm2/s for highgrade malignancies (sensitivity: 92.03%, specificity: 92.49%).
Discussion:
This echoes previous reports indicating that ADC value negatively correlated with GS, supporting the application of MP-MRI-derived parameters in the assessment of prostate cancer.
Conclusion:
Correlation of MP-MRI-derived imaging parameters with histopathology results allows meaningful exploitation in clinical decision-making in prostate cancer diagnosis. Both the PI-RADS score and the ADC value were validated as reliable predictors of tumor aggressiveness. Although MRI-targeted fusion biopsies have gained more and more popularity in clinical practice, based on our data, no conclusion can be drawn as to their effect in decreasing the number of unnecessary prostate biopsies.
