Objectives To assess the accuracy of magnetic resonance imaging (MRI)/transrectal ultrasonography (TRUS) fusion to guide first‐round biopsies in the diagnosis of localised prostate cancer (PCa) in men with a prostate‐specific antigen (PSA) ≤10 ng/mL. Patients and Methods A prospective study was conducted on men who met the following criteria: first‐round biopsy, multiparametric MRI (mpMRI) showing a lesion with a Likert score ≥2 and a PSA <10 ng/mL. All men underwent a extended 12‐core protocol plus a protocol of two or three targeted cores on the mpMRI index lesion. The UroStation™ (Koelis, Grenoble, France) and a V10 ultrasound system with an end‐fire three‐dimensional TRUS transducer were used for the fusion imaging procedure. Significant PCa was defined as: at least one core with a Gleason score of 3 + 4 or 6 with a maximum cancer core length ≥4 mm. Results A total of 152 men, whose median PSA level was 6 ng/mL, were included in the study. The proportion of positive cores was significantly higher with the targeted‐core protocol than with the extended 12‐core protocol (P < 0.001). The proportion of men with clinically significant PCa was higher with the targeted‐core protocol than with the extended 12‐core protocol (P = 0.03). The proportion of patients having at least one positive biopsy (targeted‐core protocol) was significantly different among the Likert score categories (P < 0.001). Conclusions For the first round of biopsies, MRI/TRUS‐fusion targeted biopsies detected more men with clinically significant PCa than did standard extended 12‐core biopsy alone.

IDRF assessment after neoadjuvant chemotherapy is useful for predicting completeness of resection of neurogenic tumors. A larger international study is needed to confirm these results and to explore a possible correlation between preoperative IDRF status and survival.

Magnetic resonance imaging-transrectal ultrasound fusion biopsies increased the yield of first round prostate biopsies in patients with a prostate volume greater than 40 cm(3).