ArticleBMC urology2025
Transperineal cognitive fusion MRI-targeted biopsy shows higher detection rates than systematic biopsy in prostate cancer: a prospective cohort study.
Article in BMC urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveSystematic biopsy (SBx) underdetects clinically significant prostate cancer and overdiagnoses indolent disease. This study compared the transperineal cognitive fusion targeted biopsy (COG-TBx)-which uses multiparametric MRI for precision-against SBx, evaluating their cancer detection rates and safety profiles in a clinical cohort.
methodsA total of 360 patients undergoing transperineal prostate biopsy were included, with 161 assigned to the COG-TBx group and 199 to the SBx group. Primary outcomes included PCa detection, csPCa (defined as Gleason score ≥ 3 + 4 or ISUP Level ≥ 2), and 30-day complication rates. Secondary outcomes comprised cancer detection rate per core and pathological characteristics. Statistical analyses involved χ² tests, t-tests, and multivariable logistic regression.
resultsBaseline characteristics were comparable between groups, though prostate volume was larger in the COG-TBx group (52.0 ml vs. 46.0 ml, P = 0.024). The COG-TBx group demonstrated significantly higher PCa (52.2% vs. 41.2%, P = 0.034) and csPCa detection rates (44.7% vs. 25.6%, P < 0.05), as well as a higher cancer detection rate per needle (28.5% vs. 19.3%, P = 0.003). The overall 30-day complication rate was slightly higher in the COG-TBx group (13.0% vs. 7.0%, P > 0.05), without statistical significance. Multivariate analysis identified COG-TBx (OR = 1.98, 95% CI: 1.15-3.41, P = 0.013) and PSA level (OR = 1.12 per ng/mL, 95% CI: 1.03-1.22, P = 0.008) as independent predictors of csPCa detection.
conclusionTransperineal COG-TBx is associated with higher detection rates for prostate cancer and clinically significant cancer compared to SBx. Although associated with a slightly higher complication rate, the difference was not significant. The overall benefit supports the clinical adoption of COG-TBx.
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