ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1599869
This article is part of the Research TopicEnhancing Prostate Cancer Diagnosis: Biomarkers and Imaging for Improved Patient OutcomesView all 14 articles
Assessing the Diagnostic Accuracy of Unilateral Systematic Biopsy Combined with Targeted Biopsy
Provisionally accepted
Qiang Wei1*
Qiyou Wu1
Chunlei He2Xiang Tu1
Bo Chen1Jinjiang Jiang1
Jinbao Wang1Zhouhaoran Chen3Ruoxuan Liu3Qiaoxue Huang4Bo Tang1*Jin Yao2*- 1Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 2Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 3West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- 4Guilin People’s hospital, Guilin, Guangxi Zhuang Region, China
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Background: To evaluate unilateral systematic biopsy (SB) combined with targeted biopsy (TB) and assess its diagnostic accuracy in a real-world, single-centre setting.Methods: Patients with ≥1 MRI lesion who underwent both transperineal 12-core and 3-core TB were enrolled in this study. Detection rates for total prostate cancer (PCa) and clinically significant PCa (csPCa) were compared between TB, unilateral SB+TB, and SB+TB. Pathological consistency was assessed using the kappa test, and logistic regression was used to identify potential predictors.Results: A total of 250 men were enrolled, of which 126 (50.4%) and 103 (41.2%) exhibited total PCa and csPCa, respectively. Compared to SB+TB, ipsilateral SB combined with TB (ips-SB+TB) had a comparable csPCa detection rate (99/250 vs 103/250, p=0.125), while fewer clinically insignificant PCa were detected (17/250 vs 23/250, p=0.031). In addition, ips-SB+TB demonstrated superior sensitivity for csPCa (96.1%) with an AUC of 0.98. The ips-SB+TB had a significantly higher positive core rate than SB+TB (472/2244 vs. 563/3744, p<0.001). Moreover, ips-SB+TB also had a high consistency of Gleason grade compared to SB+TB (Kappa=0.89). In the multi-lesion cohort, ips-SB+TB also had a comparable csPCa detection rate compared to SB+TB (63/128 vs. 67/128, p=0.125).Conclusions: In conclusion, our study showed that ips-SB+TB was comparable to SB+TB in detecting csPCa. The results of this study provide valuable insight into the potential of ips-SB+TB as an alternative to SB+TB.
Keywords: prostate cancer, prostate biopsy, multiparametric magnetic resonance imaging utilization, unilateral index lesion, regional biopsy
Received: 25 Mar 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Wei, Wu, He, Tu, Chen, Jiang, Wang, Chen, Liu, Huang, Tang and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiang Wei, Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
Bo Tang, Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
Jin Yao, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
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