The value of targeted MRI-US fusion biopsy in men with prior negative biopsy for prostate cancer detection

Abstract

Background Prostate cancer (PCa) is very prevalent among men, but with low mortality rates. This is mainly due to the high detection of indolent lesions that are more frequent than aggressive ones. The traditional strategy for PCa detection until recently has been the blinded random biopsies of the entire gland, called systematic biopsy (SB), by transrectal ultrasounds (TRUS) guidance. Lately, multiparametric magnetic resonance imaging (mpMRI) has been becoming a clue tool in PCa detection. Nowadays, the recommendation in men with previous negative biopsy and PCa suspicion is to perform magnetic resonance-guided biopsy (MRGB), in addition to SB, as the diagnostic procedure. The application of mpMRI in men without previous biopsy is not that supported, even though is starting to grow. There are predominantly 3 MRGB techniques. Objective To assess whether MRGB by magnetic resonance imaging-ultrasounds (MRI-US) fusion technique improves the detection rate of clinically significant PCa over SB to improve the management of prostate cancer. Design and methods In this cross-sectional single centre study, both biopsy techniques (MRGB by fusion technique and SB) will be performed to patients with a PCa suspicion and a previous negative biopsy, if the MRI is suggestive of PCa. Men whose MRI results are not suggestive of PCa will not be offered biopsy. A 12-core SB guided by TRUS will be carried out firstly before the MRGB, without any information of the MRI. The results of each technique will be compared