ArticleProstate international2026
Complementary detection of clinically significant prostate cancer by magnetic resonance imaging fusion-targeted and systematic transrectal ultrasound-guided biopsy: influence of prostate-specific antigen and prostate-specific antigen density in a retrospective paired cohort.
Article in Prostate international, 2026. 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
Background: Multiparametric magnetic resonance imaging (MRI)-targeted biopsy has improved prostate cancer detection, yet the relative diagnostic contributions of MRI-fusion-targeted biopsy and systematic transrectal ultrasound-guided (TRUS) biopsy across prostate-specific antigen (PSA) and PSA density (PSAD) levels remain uncertain. We evaluated the incremental detection of clinically significant prostate cancer (csPCa) between these techniques. Methods: This retrospective single-center paired cohort study included 376 men with biopsy-proven prostate cancer who underwent both MRI fusion-targeted and 12-core systematic TRUS biopsy in the same session for a Prostate Imaging Reporting and Data System ≥3 lesion. csPCa was defined as International Society of Urological Pathology Grade Group ≥2. Detection was compared overall and across PSA strata (<4, 4-10, 10.01-20, 20.01-50, >50 ng/mL) and PSAD groups (<0.10, 0.10-<0.15, ≥0.15 ng/mL/cc) using exact McNemar testing on discordant pairs. Results: Overall prostate cancer detection was similar between MRI fusion-targeted and systematic TRUS biopsy (318/376, 84.6% vs. 316/376, 84.0%; Conclusion: MRI fusion-targeted and systematic TRUS biopsies were complementary for csPCa detection. MRI fusion-targeted biopsy showed a numerical advantage in the intermediate PSA range, while csPCa detection increased with PSA density for both techniques. These findings support risk-stratified interpretation of biopsy yield and do not support routine omission of systematic cores when MRI-fusion-targeted biopsy is performed.
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