Multicentre assessment of transperineal targeted prostate biopsy performed as part of a targeted and systematic biopsy diagnostic strategy in men without previous prostate biopsies.
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Authors
Sheweita, Mohammed
Blaney, Liam
Oxley, Jon
Kopcke, Douglas
Bolomytis, Stefanos
Burn, Paul
Andreou, Adrian
Heron, Jon
Persad, Raj
Burns-Cox, Nick
Issue Date
2025-04-16
Type
Journal Article
Language
en
Keywords
Transperineal biopsy , biopsy concordance , clinically significant prostate cancer detection , systematic prostate biopsy , targeted prostate biopsy
Alternative Title
Abstract
Objective: To investigate the added value of systematic biopsies in men referred with suspected PCa undergoing visual registration targeted local anaesthetic transperineal prostate biopsies (LATPB) as their first biopsy for MRI-P visible lesions (MRI Score≥3) in a real-world setting.
Patients and methods: The outcomes of 2611 biopsy naïve men with MRI Score≥3 who underwent visual registration combined targeted and systematic LATPB at 5 hospitals between 2021 and 2024 were studied. The primary outcome was the clinically significant PCa (csPCa [Gleason≥ 3 + 4 = 7])) cancer detection rate at targeted prostate biopsy without upgrading contributed by the systematic component of the biopsies.
Results: Overall, PCa was diagnosed in 2079/2611 (80%) patients. The targeted biopsy csPCa detection rate in MRI Score 3,4 and 5 lesions was 108/534 (20%), 461/940 (49%) and 865/1137 (76%), respectively. The csPCa detection rate for combined biopsies in MRI Score 3, 4 and 5 lesions was 150/534 (28%), 579/940 (62%) and 959/1137 (84%). The NPV for targeted biopsies for MRI scores 3,4 and 5 lesions were 81.7%, 95% CI = (78.0%, 84.9%), 68.4%, 95% CI = (63.5%, 73.0%) and 55.7%, 95% CI = (48.0%, 63.1%), respectively. Increasing PSA-D was strongly associated with increased detection of csPCa at targeted prostate biopsy irrespective of MRI score (chi-square test p < 0.001).
Conclusions: An MRI-P and targeted prostate biopsy-only approach should be considered in all biopsy naïve men with MRI score 5 lesions and MRI score 4 lesions with a PSA Density greater than 0.15.
Patient summary: We looked at the difference between sampling a specific area of interest identified by prostate MRI compared to sampling the area of interest and additionally the prostate zones. In our study, we concluded that sampling the area of interest guided by the MRI scan alone can be more beneficial with less risk of missing out on clinically important prostate cancer in real-life practice.
Description
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,provided the original work is properly cited.© 2025 The Author(s). BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.
Citation
Sheweita, M.; Blaney, L.; Oxley, J. et al. (2025) 'Multicentre assessment of transperineal targeted prostate biopsy performed as part of a targeted and systematic biopsy diagnostic strategy in men without previous prostate biopsies', BJUI Compass. 6(4) e70020. Available At: https://doi.org/10.1002/bco2.70020
Publisher
Wiley
License
© 2025 The Author(s). BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.
Journal
BJUI compass
Volume
6
Issue
4
PubMed ID
ISSN
2688-4526