What is new?
Combined TBx+SBx provides improved detection rates particularly for
higher-grade disease over either systematic or MRI-targeted biopsy or
TRUS-Bx alone. However, superiority in significant cancer detection did
not reflect accurate Gleason Grade Group in whole prostate gland at
final surgical pathology due to selective sampling of higher grade areas
within an otherwise low grade cancer. There is a risk of overtreatment
if biopsy GGG was taken as the sole parameter for treatment decision by
TBx+SBx. Conventional TRUS-Bx has superior concordance with radical
prostatectomy for ISUP Grade 2,3,5 however increased upgrading should be
taken into account.
Key words: Prostate cancer, targeted biopsy, MRI/US Fusion,
prostate biopsy, concordance, upgrading, downgrading