Initial experience with a novel method for cognitive transperineal magnetic resonance imaging-targeted prostate biopsy

A cognitive magnetic resonance imaging(MRI)-targeted prostate biopsy conducted by an experienced clinician enhances the detection rate of(high-grade)prostate cancer;however,this method is less successful in the hands of inexperienced surgeons.Therefore,an alternative method of conducting a cognitive MRI-targeted biopsy that can be successfully performed by the inexperienced clinicians should be developed.Ninety-six males suspected of prostate cancer were analyzed using systematic biopsy and cognitive MRI-targeted biopsy based on our novel three-dimensional matrix positioning method.Typically,the core principle of the latter procedure was to put the MRI and ultrasound images into the same virtual coordinate system.Afterward,the targeted biopsy was transformed to target a coordinate for the suspected lesion in the MRI.Subsequently,patients were assessed for the presence/absence of prostate cancer or high-grade prostate cancer.According to our results,the overall detection rate of prostate cancer was 70.8%(68/96),and the detection rate of high-grade prostate cancer was 56.3%(54/96).Specifically,the detection rate of prostate cancer by systematic biopsy was 54.2%(52/96)and that by targeted biopsy was 59.4%(57/96;P=0.560).Clearly,the combined application of targeted biopsy could remarkably increase the detection rates of prostate cancer(P=0.025)and high-grade prostate cancer(P=0.009).Taken together,the findings of this study suggest that the combination of systematic biopsy with our three-dimensional matrix positioning-driven cognitive-targeted biopsy is superior to systematic biopsy in detecting prostate cancer and high-grade prostate cancer.