Transperineal systematic biopsies in addition to targeted biopsies are important in the detection of clinically significant prostate cancer

Potential Clinical Applications of Dedicated Prostate Positron Emission Tomography

The diagnosis of prostate cancer (PCa) is usually based on transrectal or transperineal biopsies (from 12 to 24 samples) in most cases after the performance of a dedicated MRI and/or transrectal ultrasound. A small-dedicated PET scanner could improve spatial resolution and increase sensitivity, allowing a precise detection and location of the PCa foci, thus allowing an image-guided biopsy. In this short review, we will focus our attention on the potential application of a dedicated prostate PET scanner and on the prototype that has been already assembled for this purpose.

MRI-Targeted Prostate Biopsy Techniques: AJR Expert Panel Narrative Review

Prostate cancer is the second most common malignancy in men worldwide. Systematic transrectal prostate biopsy is commonly used to obtain tissue to establish the diagnosis. However, in recent years, MRI-targeted biopsy (based on an MRI examination performed prior to consideration of biopsy) has been shown to detect more clinically significant cancer and less clinically insignificant cancer compared to systematic biopsy. This approach of performing MRI prior to biopsy has become, or is becoming, a standard of practice in centers throughout the world. This growing use of an MRI-directed pathway is leading to performance of a larger volume of MRI-targeted prostate biopsies. The three common MRI-targeted biopsy techniques are cognitive biopsy, MRI-ultrasound software fusion biopsy, and MRI in-bore guided biopsy. These techniques for using MRI information at the time of biopsy can be performed via a transrectal or transperineal approach. This narrative review presents the three MRI-targeted biopsy techniques along with their advantages and shortcomings. Comparisons among the techniques are summarized based on the available evidence. Studies to date have provided heterogeneous results, and the preferred technique remains debated.