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Updated: Aug 8, 2026
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Is targeted biopsy necessary for Prostate Imaging Reporting and Data System 3 lesions?
Diğdem Kuru Öz1, Sezer Nil Yılmazer Zorlu2, Nuray Haliloğlu1
1Ankara University, School of Medicine, Department of Radiology - Ankara, Turkey.
Objective:
The aim of this study was to reveal the histopathological results of Prostate Imaging Reporting and Data System 3 lesions and to investigate whether targeted biopsy is essential in these lesions.
Methods:
One hundred and twenty-seven patients with 176 lesions, being categorized as Prostate Imaging Reporting and Data System 3 according to Prostate Imaging Reporting and Data System version 2.1, who underwent transrectal ultrasound-magnetic resonance imaging fusion biopsy were included in the study.
Results:
The mean age of the patients was 62.4 years. The median of prostate-specific antigen, prostate-specific antigen density, free prostate-specific antigen, and free/total prostate-specific antigen were 6.64 ng/mL, 0.10 ng/mL2, 1.24 ng/mL, and 0.18 ng/mL, respectively. In patient- and lesion-based analysis, the prevalence of adenocarcinoma was 12.7 and 9%, and clinically significant prostate cancer was 2.3 and 1.7%, respectively. The rate of prostate cancer detected by systematic biopsy alone was 7.8%, and 1.5% of these were clinically significant. There was no significant difference in prostate-specific antigen or prostate-specific antigen density between patients with histopathologically malignant and benign Prostate Imaging Reporting and Data System 3 lesions (p≥0.233). prostate-specific antigen density was higher in malignant patients, considering only 89 patients with index lesion P3 (p=0.046). Family history was significantly higher in malignant patients (p=0.028).
Conclusion:
Since clinically significant prostate cancer is very low in Prostate Imaging Reporting and Data System 3 lesions, clinical findings and risk factors should be considered in the biopsy decision in patients with index lesion Prostate Imaging Reporting and Data System 3. However, in patients with index lesions Prostate Imaging Reporting and Data System 4 and 5, targeting these Prostate Imaging Reporting and Data System 3 areas might be important with regard to the extent of the disease.
