MP30-20 POSITIVE PRE-BIOPSY MULTIPARAMETRIC MRI OF THE PROSTATE: CAN WE RESTRICT BIOPSY TO MRI-TARGETED CORES ONLY?

INTRODUCTION AND OBJECTIVES:Multiparametric magnetic resonance imaging (mpMRI) and targeted biopsy (TBx) are increasingly being used in the diagnosis of prostate cancer (PCa). Ommitance of transrectal ultrasound (TRUS)-guided systematic biopsy (SBx) in men with a positive prebiopsy mpMRI undergoing TBx remains controversial. In this study we evaluated the additional clinical relevance of SBx in men with a positive prebiopsy mpMRI undergoing TBx for PCa detection, Gleason grading and PCa localization.METHODS:255 consecutive men with a prebiopsy positive mpMRI (PI-RADSv2: Prostate Imaging Reporting and Data System version 2 ≥3) and no prior diagnosis of PCa underwent 12-core SBx and subsequent MRI-TRUS fusion TBx in two institutions between 2015 and 2018. Detection rates for clinically significant (cs)PCa (Gleason score (GS)≥3+4) and insignificant PCa (GS=3+3) for TBx and SBx were compared with the McNemar test. We determined the number of missed and GS undergraded csPCa on TBx and SBx. We evaluated the rol...