31a542a3a367179ac7eaa7b3d58ae1d9 diagnostics-15-00288-v2.pdf 7af634c7c9b3b479622196d3439654d40482783e diagnostics-15-00288-v2.pdf 8ff7e70deef3d61ad39af80a6f4b0e739110b837be40132baa01edb23e666b50 diagnostics-15-00288-v2.pdf Title: Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study Subject: Background: 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. Methods: 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. Results: Transperineal and transrectal biopsies detected sPCa in 49.5% vs. 40.6% overall(p = 0.027), 44.6% vs. 30.8% from index lesions (p = 0.001), and 24.3% vs. 35.1% from systematic biopsies (p = 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, p = 0.039, and 52.9% vs. 24.2% at the apex, p = 0.024) and central zone (33.3% vs. 5.9%, p = 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 (p = 0.012). Conclusions: 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. Keywords: prostate biopsy; magnetic resonance imaging; target biopsy; transperineal; transrectal; prostate cancer 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 and Juan Morote Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Mon Apr 7 09:40:46 2025 CEST ModDate: Tue Apr 8 03:41:43 2025 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 480071 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WNWTFR+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 AIRHKL+VnURWPalladioL Type 1 Custom yes yes yes 16 0 BPZWFV+URWPalladioL-Roma Type 1 Custom yes yes yes 21 0 JRFCTW+URWPalladioL-Bold Type 1 Custom yes yes yes 27 0 SGLAFX+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 DNJKIN+Symbol Type 1C Custom yes yes yes 68 0 DNJKHM+Calibri CID TrueType Identity-H yes yes yes 73 0 DNJKIO+Arial CID TrueType Identity-H yes yes yes 79 0 DNJJJJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 85 0 DNJJJK+PalatinoLinotype CID TrueType Identity-H yes yes yes 88 0 DNJJJL+PalatinoLinotype TrueType WinAnsi yes yes no 94 0 DNJJJM+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 97 0 DNJJJN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 103 0 DNJJPN+PalatinoLinotype TrueType MacRoman yes yes no 106 0 DNJKHL+Calibri,Bold CID TrueType Identity-H yes yes yes 109 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 124 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-05-28 02:09:32 CEST RepresentationInformation: diagnostics-15-00288-v2.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-05-27 15:02:03 CEST Size: 480071 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 262 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design, Setting, and Participants Destination: subsection.2.1 Item: Title: PCa Diagnostic Approach Destination: subsection.2.2 Item: Title: Variables in the Study Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of Cohort Study Destination: subsection.3.1 Item: Title: Binary Logistic Regression for Searching Independent Predictive Variables of sPCa, Selection of a Matched Group to Avoid Confounders, and Characteristics of Paired Groups Destination: subsection.3.2 Item: Title: Overall Efficacy of Systematic Biopsies According to the Prostate Biopsy Route Destination: subsection.3.3 Item: Title: Overall Efficacy of Guided Biopsies to the Index Lesion According to the Biopsy Routeand Localizations Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired Matched Study 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 and Juan Morote Subject: Background: 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. Methods: 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. Results: Transperineal and transrectal biopsies detected sPCa in 49.5% vs. 40.6% overall(p = 0.027), 44.6% vs. 30.8% from index lesions (p = 0.001), and 24.3% vs. 35.1% from systematic biopsies (p = 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, p = 0.039, and 52.9% vs. 24.2% at the apex, p = 0.024) and central zone (33.3% vs. 5.9%, p = 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 (p = 0.012). Conclusions: 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. 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