Transperineal Magnetic Resonance Imaging-Fusion Targeted Prostate Biopsy Utilizing the PrecisionPoint Transperineal Access System vs a Grid Template: An Assessment of Outcomes.

OBJECTIVE

To compare PrecisionPoint and grid-based biopsies on rates of clinically significant prostate cancer (csPCa) detection and complications when transperineal MRI-fusion targeted biopsy is performed.

MATERIALS AND METHODS

We queried a prospectively maintained prostate biopsy database to identify men ages 18-89 who underwent transperineal MRI-fusion targeted prostate biopsies (including concurrent systematic biopsies) between August 1, 2020 and September 1, 2024. The primary outcome was detection of csPCa in the MRI region of interest. 30-day complications and overall rates of csPCa were examined at the patient level. Subgroup outcomes included cancer detection in anterior MRI lesions and stratification by prior biopsy status. Logistic regression was performed.

RESULTS

1134 MRI lesions in 890 patients were included in the analysis (PrecisionPoint: 542 patients/714 lesions; grid-based biopsy: 348 patients/420 lesions). There were no differences in prostate cancer detection between the two groups overall. For patients with a prior negative biopsy, a grid-based approach detected a higher rate of csPCa (P=.021). On logistic regression, biopsy approach was not a significant predictor of csPCa at either the patient (P=.797) or lesion (P=.473) levels. Complication rates and the ability to detect csPCa in anterior lesions were similar between approaches.

CONCLUSION

PrecisionPoint and grid-based biopsies identified similar rates of prostate cancer, including in anterior MRI lesions, when transperineal MRI-targeted prostate biopsy was performed in this cohort. Complication rates were low and did not differ based on technique.