The Comparison of Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Biopsies with Conventional Transrectal Biopsies in Prostate Cancer Detection

Objective: The conventional technique for histological prostate cancer diagnosis is transrectal ultrasound (TRUS)-guided random sampling of the peripheral prostate zone. However, due to method insufficiency and recent developments in prostate imaging, new biopsy methods were introduced. This study aimed to evaluate prostate cancer detection rates by the standard and magnetic resonance (MR) fusion biopsy methods. The main purpose of our study is to mutually evaluate prostate cancer detection rates and results of standard and cognitive MR fusion biopsy methods and share our experiences in this process. Materials and Methods: Patients, who underwent prostate biopsy due to elevated serum prostate-specific antigen levels (>4ng/mL) and/or suspicious rectal examination, were retrospectively evaluated. A total of 160 patients were included in the study between January 2018 and January 2021. Patients were divided into two groups according to the applied method, as standard biopsy (SB) and MR fusion biopsy. Results: Prostate cancer was reported in 25 (31.3%) of 80 patients who underwent SB, wherein 20 (25%) were determined with clinically significant cancer. Prostate cancer was reported in 30 (37.5%) of 80 patients who underwent MR fusion biopsy, wherein 25 (31%) were reported as clinically significant cancer. A statistically significant difference was found in detecting prostate cancer and clinically significant prostate cancer when the prostate imaging-Reporting and Data System (3,4,5) scores were compared with each other (p<0.05, p=0.00). The additional SB to MR-targeted fusion biopsy was statistically significant in prostate cancer diagnosis (p=0.01, p<0.05). Conclusion: The additional SB to targeted biopsy increased the detection rate of clinically significant prostate cancer. Larger randomized studies are needed to reach a consensus on the ideal biopsy technique.