Comparison of MRI-guided in-bore and fusion biopsy for small PI-RADS 4 prostate lesions.

Authors

Hatice Zoroğlu, Serdar Madendere, Kayhan Tarım, Mert Veznikli, Selahattin Durmaz, Metin Vural, Barbaros Erhan Çil, Bengi Gürses, Umutcan Karaarslan, Barış Esen, Yakup Kordan, Derya Tilki, Tarık Esen

Published in

World journal of urology. Volume 44. Issue 1. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

We compared prostate cancer (PC) and clinically significant prostate cancer (csPC) identification performances of MRI-guided in-bore (IB) and software-fusion biopsy (SFB) techniques among small volume PI-RADS 4 index lesions.
We retrospectively reviewed 268 biopsy-naïve patients with 308 small volume PI-RADS 4 index lesions (≤ 7 mm in greatest dimension) on multiparametric prostate MRI and subsequent IB and SFB between January 2010 and December 2025. All IBs were performed by a single radiologist on 134 patients, while another radiologist and a urologist performed SFBs on the remaining 134 patients. Patient and lesion characteristics in both groups were analyzed. A multivariable binary logistic regression model was constructed to identify independent predictors of csPC.
Median age was 67 in both cohorts. Median PSA value was 5.1 and 6 ng/ml, PSA density was 0.11 and 0.09 ng/ml/cm³ in IB and SFB cohorts, respectively. Among 308 PI-RADS 4 lesions ≤ 7 mm, PC was identified in 169 (54.9%) lesions, while csPC was identified in 94 (30.8%) lesions. IB technique revealed 60.1% and 41.9% PC and csPC among 148 lesions. SFB technique revealed PC and csPC rates of 50% and 20.6%, respectively, among 160 lesions. In-bore biopsy technique (p < 0.001), PSAD (p = 0.001) and number of cores (p = 0.010) were independent predictors of csPC on multivariate analysis.
Our study indicates that a significant proportion of small PI-RADS 4 index lesions may harbor csPC. Regarding small PI-RADS 4 lesions, IB technique was superior to SFB in detection of csPC.

PMID:
42406173
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.