The Added Value of Systematic Sampling in In-Bore Magnetic Resonance Imaging-Guided Prostate Biopsy

SIMPLE SUMMARY: We quantified the additive diagnostic value of systematic biopsy (SB) using in-bore magnetic resonance-guided prostate biopsy (IBMRGpB) by retrospectively reviewing 189 records of patients who were suspected to have prostate cancer or were previously diagnosed with prostate cancer. Sixty-seven (35.5%) patients had positive findings. SB from the lobe contralateral to the lesion detected clinically significant disease in 15 (12%) patients. The prostate size was larger and the number of lesions in the peripheral zone was greater in men with positive SB findings compared to those with negative SB findings. Main lesions located in the peripheral zone of the prostate were predictive of clinically significant disease, a finding supported by a subgroup analysis of biopsy-naïve patients. Adding SB to IBMRGpB increased the capability of diagnosing both clinically significant and non-clinically significant prostate cancer. These findings may enhance patient-tailored management. ABSTRACT: We sought to quantify the additive value of systematic biopsy (SB) using in-bore magnetic resonance (MR)-guided prostate biopsy (IBMRGpB) by retrospectively reviewing the records of 189 patients who underwent IBMRGpB for suspected prostate cancer or as part of the surveillance protocol for previously diagnosed prostate cancer. The endpoints included clinically significant and non-clinically significant cancer diagnosis. SB detected clinically significant disease in 67 (35.5%) patients. Five (2.65%) patients whose targeted biopsies indicated benign or non-clinically significant disease had clinically significant disease based on SB. SB from the lobe contralateral to the lesion detected clinically significant disease in 15 (12%) patients. The size of the prostate was larger and the percentage of lesions located in the peripheral zone of the prostate was higher in patients with SB-detected clinically significant disease. The location of the main lesion in the peripheral zone of the prostate was a predictor for clinically significant disease in the multivariate analysis (OR = 8.26, p = 0.04), a finding supported by a subgroup analysis of biopsy-naïve patients (OR = 10.52, p = 0.034). The addition of SB during IBMRGpB increased the diagnosis of clinically significant as well as non-clinically significant prostate cancer. The location of the main lesion in the peripheral zone emerged as a positive predictive factor for clinically significant disease based on SB. These findings may enhance patient-tailored management.