Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study
<b>Background</b>: A transperineal approach to prostate biopsy is now recommended to reduce the risk of infectious complications associated with the transrectal route. Our aim is to compare the efficacy of transrectal- and transperineal-guided biopsies involving the magnetic resonance im...
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2025-01-01
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| author | Nahuel Paesano Natàlia Picola Jesús Muñoz-Rodriguez Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Ana Celma Gemma García-de Manuel Berta Miró Pol Servian José M. Abascal Enrique Trilla Juan Morote |
| author_facet | Nahuel Paesano Natàlia Picola Jesús Muñoz-Rodriguez Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Ana Celma Gemma García-de Manuel Berta Miró Pol Servian José M. Abascal Enrique Trilla Juan Morote |
| author_sort | Nahuel Paesano |
| collection | DOAJ |
| description | <b>Background</b>: A transperineal approach to prostate biopsy is now recommended to reduce the risk of infectious complications associated with the transrectal route. Our aim is to compare the efficacy of transrectal- and transperineal-guided biopsies involving the magnetic resonance imaging (MRI) of index lesions in detecting significant prostate cancer (sPCas), and to evaluate the role of systematic biopsies. <b>Methods</b>: In a prospective and multicenter trial conducted in an opportunistic early detection program for sPCa in Catalonia (Spain), between 2021 and 2023, 4029 men suspected of having PCa underwent multiparametric MRI followed by guided and systematic biopsies. From this cohort, we retrospectively selected 1376 men with reports of the size and localization of their index lesions. A matched group of 325 pairs of men subjected to transrectal and transperineal biopsy were chosen to account for confounding variables. We compared sPCa detection rates determined via index lesions and systematic biopsies, as well as by lesion localization. <b>Results</b>: Transperineal and transrectal biopsies detected sPCa in 49.5% vs. 40.6% overall (<i>p</i> = 0.027), 44.6% vs. 30.8% from index lesions (<i>p</i> = 0.001), and 24.3% vs. 35.1% from systematic biopsies (<i>p</i> = 0.003). SPCa detection rates were higher in transperineal biopsies across all index lesion localizations, with significant increases in the anterior zone (47.8% vs. 20.8% at the mid-base, <i>p</i> = 0.039, and 52.9% vs. 24.2% at the apex, <i>p</i> = 0.024) and central zone (33.3% vs. 5.9%, <i>p</i> = 0.003). With regards to SPCa detected only in systematic biopsies, 10.5% of cases were detected in transrectal biopsies and 4.9% of cases were detected in transperineal biopsies (<i>p</i> = 0.012). <b>Conclusions</b>: Targeted biopsies conducted via the transperineal route showed higher sPCa detection rates than transrectal biopsies, particularly for anterior and apical lesions, with systematic biopsies showing reduced utility. |
| format | Article |
| id | doaj-art-78971452264243828e4209df6cfbe5dd |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-78971452264243828e4209df6cfbe5dd2025-08-20T02:48:09ZengMDPI AGDiagnostics2075-44182025-01-0115328810.3390/diagnostics15030288Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched StudyNahuel Paesano0Natàlia Picola1Jesús Muñoz-Rodriguez2Xavier Ruiz-Plazas3Marta V. Muñoz-Rivero4Ana Celma5Gemma García-de Manuel6Berta Miró7Pol Servian8José M. Abascal9Enrique Trilla10Juan Morote11Clínica Creu Blanca, 08018 Barcelona, SpainDepartment of Urology, Hospital Universitari de Bellvitge, 08907 Hospitalet de Llobregat, SpainDepartment of Urology, Hospital Universitari Parc Tauli, 08208 Sabadell, SpainDepartment of Urology, Hospital Universitari Joan XXIII, 43005 Tarragona, SpainDepartment of Urology, Hospital Universitari Arnau de Vilanova, 25198 Lleida, SpainDepartment of Urology, Hospital Univeritari Vall d’Hebron, 08035 Barcelona, SpainDepartment of Urology, Hospital Universitari Josep Trueta, 17007 Girona, SpainStatistic Unit, Vall d’Hebron Research Institute, 08035 Barcelona, SpainDepartment of Urology, Hospital Univeritari Germans Trias i Pujol, 08916 Badalona, SpainDepartment of Urology, Parc de Salut Mar, 08003 Barcelona, SpainDepartment of Surgery, Universitat Autònoma de Barcelona, 08193 Bellaterra, SpainDepartment of Surgery, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain<b>Background</b>: A transperineal approach to prostate biopsy is now recommended to reduce the risk of infectious complications associated with the transrectal route. Our aim is to compare the efficacy of transrectal- and transperineal-guided biopsies involving the magnetic resonance imaging (MRI) of index lesions in detecting significant prostate cancer (sPCas), and to evaluate the role of systematic biopsies. <b>Methods</b>: In a prospective and multicenter trial conducted in an opportunistic early detection program for sPCa in Catalonia (Spain), between 2021 and 2023, 4029 men suspected of having PCa underwent multiparametric MRI followed by guided and systematic biopsies. From this cohort, we retrospectively selected 1376 men with reports of the size and localization of their index lesions. A matched group of 325 pairs of men subjected to transrectal and transperineal biopsy were chosen to account for confounding variables. We compared sPCa detection rates determined via index lesions and systematic biopsies, as well as by lesion localization. <b>Results</b>: Transperineal and transrectal biopsies detected sPCa in 49.5% vs. 40.6% overall (<i>p</i> = 0.027), 44.6% vs. 30.8% from index lesions (<i>p</i> = 0.001), and 24.3% vs. 35.1% from systematic biopsies (<i>p</i> = 0.003). SPCa detection rates were higher in transperineal biopsies across all index lesion localizations, with significant increases in the anterior zone (47.8% vs. 20.8% at the mid-base, <i>p</i> = 0.039, and 52.9% vs. 24.2% at the apex, <i>p</i> = 0.024) and central zone (33.3% vs. 5.9%, <i>p</i> = 0.003). With regards to SPCa detected only in systematic biopsies, 10.5% of cases were detected in transrectal biopsies and 4.9% of cases were detected in transperineal biopsies (<i>p</i> = 0.012). <b>Conclusions</b>: Targeted biopsies conducted via the transperineal route showed higher sPCa detection rates than transrectal biopsies, particularly for anterior and apical lesions, with systematic biopsies showing reduced utility.https://www.mdpi.com/2075-4418/15/3/288prostate biopsymagnetic resonance imagingtarget biopsytransperinealtransrectalprostate cancer |
| spellingShingle | Nahuel Paesano Natàlia Picola Jesús Muñoz-Rodriguez Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Ana Celma Gemma García-de Manuel Berta Miró Pol Servian José M. Abascal Enrique Trilla Juan Morote Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study Diagnostics prostate biopsy magnetic resonance imaging target biopsy transperineal transrectal prostate cancer |
| title | Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study |
| title_full | Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study |
| title_fullStr | Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study |
| title_full_unstemmed | Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study |
| title_short | Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study |
| title_sort | efficacy of prostate biopsies via transperineal and transrectal routes for significant prostate cancer detection a multicenter paired matched study |
| topic | prostate biopsy magnetic resonance imaging target biopsy transperineal transrectal prostate cancer |
| url | https://www.mdpi.com/2075-4418/15/3/288 |
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