Objectives: To explore the performance of targeted biopsy (TB) in combination with systematic biopsy (SB) in the detection of prostate cancer (PCa) in biopsy naïve patients.
Methods: From May 2018 to January 2020, 230 biopsy-naïve men with suspicious bi-parametric MRI [bpMRI; Prostate Imaging Reporting and Data System (PI-RADS) score ≥3] were enrolled. All patients had prostate-specific antigen (PSA) levels of 20 ng/ml or less. For each patient, transrectal ultrasound-guided prostate biopsy was performed. The primary endpoint was the detection rate of CSPC [clinically-significant PCa, International Society of Urological Pathology grade group (ISUP GG) 2 or higher tumors]. The secondary endpoints were the detection rates of CIPC (clinically insignificant PCa, ISUP GG 1 tumors).
Results: CSPC was detected in 90 patients. Twelve (13.33%) of them were detected by TB only and 18 (20.00%) by SB only. Detection of CSPC by SB and TB did not differ significantly (p = .36). In 4.35% of 230 patients, CSPC would have been missed if we performed SB only, and in 6.09% of patients if we performed TB only. Moreover, combination of TB and SB did not increase the detection of CIPC.
Conclusions: No significant difference was found in the detection of CSPC between TB and SB; however, both techniques revealed substantial added value and combination of TB and SB could further improve this detection rate without increasing the detection of CIPC.
Keywords: Prostate cancer; bi-parametric magnetic resonance imaging; biopsy naïve; cancer detection rate; targeted biopsy.