Efficacy of MRI/US guided fusion biopsy with transperineal approach for histological verification of clinically significant prostate cancer localized in the anterior fibromuscular stroma of the prostate
Abstract
Introduction: Prostate cancer necessitates precise diagnostic methods to ensure
timely and appropriate treatment. The advancement of magnetic resonance imaging (MRI), combined in real-time with ultrasound (US) via fusion technology,
has enabled enhanced targeted biopsy capabilities. Tumors located within the
anterior fibromuscular stroma have traditionally posed significant challenges
for histological verification due to limited accessibility by transrectal biopsy. The
adoption of a transperineal approach significantly improves diagnostic efficacy in
this anatomically challenging region.
Objective: The present study aims to evaluate the diagnostic performance of
MRI/US fusion biopsy via transperineal access in detecting clinically significant
prostate cancer localized in the anterior zone.
Materials and Methods: A retrospective analysis was performed on patient
data collected from January 2023 to June 2025. All patients with elevated total
prostate-specific antigen (tPSA) levels underwent MRI assessment with lesions
scored according to PI-RADS criteria. Patients presenting with lesions localized to
the anterior zone and rated PI-RADS 3 or higher underwent MRI/US fusion-guided
transperineal biopsy. Histopathological outcomes were subsequently analyzed.
Results: The cohort consisted of 508 patients, of whom 19.7% (100 patients)
demonstrated MRI-detected lesions localized in the anterior zone. The mean age
within this subgroup was 66.9 ± 9.2 years. Mean tPSA was 13.6 ± 9.1…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 508 participants or records.
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