Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer.

Abstract

This retrospective study assessed the diagnostic accuracy of targeted biopsy (TB) and unilateral systematic biopsy in detecting clinically significant prostate cancer (csPCa) in 222 men with single magnetic resonance imaging (MRI) lesions (Prostate Imaging Reporting and Data System [PI-RADS] ≥ 3). Patients underwent multiparametric MRI and MRI/ultrasound fusion TB and 12-needle standard biopsy (SB) from September 2016 to June 2021. The study compared the diagnostic performance of TB + iSB (ipsilateral), TB + contralateral system biopsy (cSB) (contralateral), and TB alone for csPCa using the χ 2 test and analysis of variance. Among 126 patients with csPCa (ISUP ≥ 2), detection rates for TB + iSB, TB + cSB, and TB were 100, 98.90, and 100% for lesions, respectively. TB + iSB showed the highest sensitivity and negative predictive value. No significant differences in accuracy were found between TB + iSB and the gold standard for type 3 lesions (P = 1). For types 4-5, detection accuracy was comparable across methods (P = 0.314, P = 0.314, P = 0.153). TB had the highest positive needle count rate, with TB + iSB being second for type 3 lesions (4.08% vs 6.57%, P = 0.127). TB + iSB improved csPCa detection rates and reduced biopsy numbers, making it a viable alternative to TB + SB for single MRI lesions.