Author(s)

Kevin Chang Yue Wei¹, Lee Say Bob¹, Devindran Manoharan¹, Liong Men Long², Teoh Sze Yong^3,4, Teo Rui Ling¹, Chua Zi Wei^3*

¹Department of Urology, Hospital Pulau Pinang, George Town, Malaysia.
²Department of Urology, Georgetown Specialist Hospital, George Town, Malaysia.
³Department of Radiology, Hospital Pulau Pinang, George Town, Malaysia.
⁴Department of Radiology, Georgetown Specialist Hospital, George Town, Malaysia.

Introduction: Prostate cancer (PCa) is the third most prevalent cancer among Malaysian males, often diagnosed at advanced stages, leading to suboptimal outcomes. While transrectal ultrasound-guided systematic biopsy (TRUS-SB) is the primary diagnostic method, prebiopsy multiparametric magnetic resonance imaging (mpMRI) is gaining popularity in identifying suspicious lesions. This study addresses the lack of comprehensive investigations into the efficacy of cognitive registration TRUS targeted biopsy (COG-TB) compared to conventional TRUS-SB, considering the resource limitations of the Malaysian healthcare system. Materials and Methods: A retrospective cohort study was conducted in two Malaysian healthcare facilities. 116 adult patients with a prostate-specific antigen (PSA) level of more than 4 ng/mL who underwent both COG-TB and TRUS-SB between October 2020 and March 2022 were included. Primary outcomes were cancer detection rate and histopathological outcomes, including Gleason score. Results: COG-TB showed a higher overall cancer detection rate (50%) compared to TRUS-SB (44%). Clinically significant cancer detection rates were similar between COG-TB and TRUS-SB (37.1%). Further analysis revealed that both COG-TB and TRUS-SB detected clinically significant cancer in 30.2% of patients, did not detect it in 56.0%, and had conflicting findings in 16 patients (p < 0.001). COG-TB detected more Gleason score 6 (15 versus 8) and Gleason score 8 (5 versus 3) cases than TRUS-SB. However, COG-TB also detected more insignificant prostate cancers (12.9%) compared to TRUS-SB (6.9%). Conclusion: COG-TB and TRUS-SB have comparable detection rates for clinically significant prostate cancer, with COG-TB showing a higher tendency to detect insignificant prostate cancer. Further studies comparing these methods are warranted.

Prostate Cancer, Multiparametric MRI, Targeted Biopsy, Cognitive Fusion, Transrectal Ultrasound-Guided Biopsy

Wei, K. , Bob, L. , Manoharan, D. , Long, L. , Yong, T. , Ling, T. and Wei, C. (2024) Comparison of Cognitive Registration Transrectal Ultrasound-Guided Targeted Biopsy of Prostate to Systematic 12-Core Biopsy: A Retrospective, Multicentre Study. Open Journal of Urology, 14, 381-390. doi: 10.4236/oju.2024.147040.