Systematic and Targeted Prostate Biopsy: a Five-Year Experience in a High-Volume Center

Abstract

Prostate biopsy is the gold standard diagnostic tool for prostate cancer. The number of targeted prostate biopsies based on multiparametric resonance imaging have increased in recent years, and this method is becoming increasingly utilized in patients in repeat biopsy settings, but also for biopsy-naive patients. The aim of this study was to analyze and present our results for the purpose of self-control and education. In the time period between January 2018 and December 2022, there were a total of 3385 prostate biopsies performed at the University Hospital Centre Zagreb. There were 2636 systematic (12 core) and 749 cognitive targeted biopsies, with an increasing trend in favor of targeted biopsy. The positivity of systematic biopsy was 45%, whereas positivity for targeted biopsies was 53.3%. The positivity of PI-RADS 3 lesions for targeted biopsies was 35%, 61% for PI-RADS 4, and 86% for PI-RADS 5. The median number of positive systematic cores was 3, and 4 cores for targeted biopsies, while the median cancer core involvements were 30% for systematic and 60% for targeted cores. In targeted cores, there was a higher percentage of ISUP grade 2 and 3 cancers when compared with systematic cores. Targeted biopsy is a valuable addition to the standard systematic biopsy in patients with suspicious lesions described on mpMRI.

Keywords

• Prostate cancer
• Prostate biopsy
• Targeted prostate biopsy
• mpMRI