Transperineal systematic biopsies in addition to targeted biopsies are important in the detection of clinically significant prostate cancer.
BACKGROUND
This study aimed to determine whether the addition of transperineal systematic biopsies (SB) to targeted biopsies (TB) improved clinically significant prostate cancer (csPC) detection rates without high increase in insignificant prostate cancer detection rates in an Australian population.


METHODS
In this retrospective review, a total of 254 patients who had a Prostate Imaging-Reporting and Data System score between 3 and 5, and a transperineal TB and SB between 2014 and 2019 from two centres were included in this study. The primary outcome of this study was to determine csPC rates on TB and SB. The secondary outcome was a comparison of the Gleason Grade Group between TB and SB. csPC was defined as an International Society of Urological Pathology Gleason Grade Group of 2 or greater.


RESULTS
SB alone detected more csPC overall compared to TB (152/254 (60%) versus 128/254 (51%), respectively). An additional 40 of 254 (16%) csPC cases were diagnosed with the addition of SB. Furthermore, the cost of diagnosing insignificant prostate cancer by SB when TB were negative was an additional 13/254 (5.1%).


CONCLUSION
A combination of TB and SB provides the best outcomes for detecting csPC and is especially warranted for patients with a higher Prostate Imaging-Reporting and Data System score on multiparametric magnetic resonance imaging.
['Lahoud|John|J|0000-0002-6991-3233', 'Doan|Paul|P|0000-0003-4946-7982', 'Kim|Lawrence H|LH|0000-0002-4732-0082', 'Patel|Manish I|MI|0000-0003-1409-9171']
D001315:Australia D006801:Humans D061705:Image-Guided Biopsy D008279:Magnetic Resonance Imaging D008297:Male D011446:Prospective Studies D011471:Prostatic Neoplasms D012189:Retrospective Studies D018084:Ultrasonography, Interventional
Systematic biopsy Targeted Prostate cancer magnetic resonance imaging