Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?

ABSTRACT Purpose: The accurate diagnosis of prostate cancer (PCa) remains challenging, particularly because standard biopsy techniques do not routinely include anterior zone, leading to potential missed diagnoses in this region. This study evaluates the accuracy and safety of biplanar stereotactic...

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Main Authors: Zeng Zhou, Tiewen Li, Yichen Zhang, Xuehao Zhou, Xiaohai Wang, Di Cui, Yiping Zhu, Chenyi Jiang, Wenhuan Guo, Bangmin Han, Yuan Ruan
Format: Article
Language:English
Published: Sociedade Brasileira de Urologia 2025-03-01
Series:International Brazilian Journal of Urology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000200405&lng=en&tlng=en
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author Zeng Zhou
Tiewen Li
Yichen Zhang
Xuehao Zhou
Xiaohai Wang
Di Cui
Yiping Zhu
Chenyi Jiang
Wenhuan Guo
Bangmin Han
Yuan Ruan
author_facet Zeng Zhou
Tiewen Li
Yichen Zhang
Xuehao Zhou
Xiaohai Wang
Di Cui
Yiping Zhu
Chenyi Jiang
Wenhuan Guo
Bangmin Han
Yuan Ruan
author_sort Zeng Zhou
collection DOAJ
description ABSTRACT Purpose: The accurate diagnosis of prostate cancer (PCa) remains challenging, particularly because standard biopsy techniques do not routinely include anterior zone, leading to potential missed diagnoses in this region. This study evaluates the accuracy and safety of biplanar stereotactic biopsy for diagnosing anterior clinically significant PCa (csPCa). Materials and Methods: After propensity score matching analysis, data from 256 patients were retrospectively analyzed, including 128 in the biplanar group (transrectal targeted biopsy with transperineal systematic biopsy) and 128 in the monoplanar group (transperineal targeted biopsy with transperineal systematic biopsy). PCa detection rates, lesion locations, csPCa, clinically insignificant PCa (ciPCa), and complication incidences were compared. Univariable and multivariable logistic regression models evaluated factors influencing biopsy outcomes. Results: No significant differences were observed in overall PCa detection, ciPCa, posterior lesions, or postoperative complications between biplanar and monoplanar groups. The biplanar group demonstrated a higher detection rate for anterior csPCa (P=0.025). The overall International Society of Urological Pathology grade group (ISUP GG) distributions for Prostate Imaging Reporting and Data System (PI-RADS) scores 3 to 5 were not significantly different. Logistic regression identified age and PSA levels as independent predictors of higher detection rates, while univariable analysis showed that prostate volume had a significantly smaller effect on PCa detection rates in the biplanar group compared to the monoplanar group. Postoperative complications showed no statistically significant differences. Conclusions: In conclusion, biplanar stereotactic biopsy was superior to monoplanar biopsy in detecting anterior csPCa. Both methods demonstrated no significant differences in overall PCa detection rates and safety.
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spelling doaj-art-cf3d3937a8f64fae95439db3fe2c89632025-08-20T02:08:42ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192025-03-0151210.1590/s1677-5538.ibju.2024.0630Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?Zeng Zhouhttps://orcid.org/0009-0009-2640-7419Tiewen LiYichen ZhangXuehao ZhouXiaohai WangDi CuiYiping ZhuChenyi JiangWenhuan GuoBangmin HanYuan RuanABSTRACT Purpose: The accurate diagnosis of prostate cancer (PCa) remains challenging, particularly because standard biopsy techniques do not routinely include anterior zone, leading to potential missed diagnoses in this region. This study evaluates the accuracy and safety of biplanar stereotactic biopsy for diagnosing anterior clinically significant PCa (csPCa). Materials and Methods: After propensity score matching analysis, data from 256 patients were retrospectively analyzed, including 128 in the biplanar group (transrectal targeted biopsy with transperineal systematic biopsy) and 128 in the monoplanar group (transperineal targeted biopsy with transperineal systematic biopsy). PCa detection rates, lesion locations, csPCa, clinically insignificant PCa (ciPCa), and complication incidences were compared. Univariable and multivariable logistic regression models evaluated factors influencing biopsy outcomes. Results: No significant differences were observed in overall PCa detection, ciPCa, posterior lesions, or postoperative complications between biplanar and monoplanar groups. The biplanar group demonstrated a higher detection rate for anterior csPCa (P=0.025). The overall International Society of Urological Pathology grade group (ISUP GG) distributions for Prostate Imaging Reporting and Data System (PI-RADS) scores 3 to 5 were not significantly different. Logistic regression identified age and PSA levels as independent predictors of higher detection rates, while univariable analysis showed that prostate volume had a significantly smaller effect on PCa detection rates in the biplanar group compared to the monoplanar group. Postoperative complications showed no statistically significant differences. Conclusions: In conclusion, biplanar stereotactic biopsy was superior to monoplanar biopsy in detecting anterior csPCa. Both methods demonstrated no significant differences in overall PCa detection rates and safety.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000200405&lng=en&tlng=enProstatic NeoplasmsUltrasound, High-Intensity Focused, TransrectalDiagnosis
spellingShingle Zeng Zhou
Tiewen Li
Yichen Zhang
Xuehao Zhou
Xiaohai Wang
Di Cui
Yiping Zhu
Chenyi Jiang
Wenhuan Guo
Bangmin Han
Yuan Ruan
Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?
International Brazilian Journal of Urology
Prostatic Neoplasms
Ultrasound, High-Intensity Focused, Transrectal
Diagnosis
title Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?
title_full Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?
title_fullStr Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?
title_full_unstemmed Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?
title_short Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Approaches be Combined for Prostate Cancer Detection?
title_sort biplanar or monoplanar prostate biopsy should transrectal and transperineal approaches be combined for prostate cancer detection
topic Prostatic Neoplasms
Ultrasound, High-Intensity Focused, Transrectal
Diagnosis
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000200405&lng=en&tlng=en
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