Are targeted prostate biopsies ready to replace systematic prostate biopsies

Abstract Objectives To evaluate the efficacy and efficiency of systematic prostatic biopsy (SPB) and cognitive fusion PB (CFPB) to diagnose Prostate Cancer (PCa) and significant PCa (SPCa), and to analyse if CFPB could safely replace SPB. Material and methods A cohort of 314 consecutive men having PI-RADS ≥2 in a pre-biopsy 3T mp-MRI were prospectively subjected to trans-rectal ultrasound CFPB (two cores per suspicious area until a maximum of three areas) and a 12 peripheral core SPB. SPCa was considered when the WHO grade was higher than 2 (Gleason 4 + 3 or higher). Results PCa was diagnosed in 133 patients (42.4%), being 83 (62.4 %) SPCa. SPB detected PCa in 114 men (85.7%) while CFPB in 103 (77.4%), p  Conclusions CFPB are more effective and also more efficient than SPBs in detecting SPCa. However, CFPBs still cannot safely replace SPBs because they are not able to detect up to 15% of SPCa.