Cancer Detection Rates in Targeted Transperineal MRI-TRUS Elastic Fusion-guided Prostate Biopsies Performed Under Local Anesthesia

Anticancer Res. 2021 Sep;41(9):4395-4400. doi: 10.21873/anticanres.15244. Epub 2021 Sep 1.


Background/aim: The aim of this study was to evaluate the cancer detection rate (CDR) using magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion-guided transperineal targeted biopsy (TB).

Patients and methods: We included 401 consecutive patients, of which 161 were biopsy-naïve. All underwent prebiopsy bi-parametric MRI; patients with positive MRI [prostate imaging reporting and data system (PI-RADS≥3)] underwent TB. Biopsy-naïve patients with positive MRI underwent TB and systematic biopsies (SBs). MRI-negative patients underwent SBs. Clinically significant prostate cancer (csPCa) was defined as ISUP ≥2. The added value of SB was defined as an upgrade from a negative biopsy or ISUP of 1 in TB to csPCa in SB.

Results: The median (interquartile range) age was 69 (range=63-74) years, and PSA was 6.9 (range=4.5-11) ng/ml. The overall CDR was 65%, with csPCa occurring in 48%. In cases of PI-RADS 5, CDR was 91%, and csPCa was 77%. The added value of SB was 2%.

Conclusion: Transperineal TB biopsies using MRI-TRUS fusion yield a high CDR.

Keywords: MRI-TRUS image fusion; Prostate cancer; cancer detection rate; local anesthesia; outpatient setting; transperineal prostate biopsy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods*
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Multiparametric Magnetic Resonance Imaging / methods*
  • Prospective Studies
  • Prostate-Specific Antigen / metabolism
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / pathology*
  • Sensitivity and Specificity


  • Prostate-Specific Antigen