With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be considering introducing the technique of magnetic resonance imaging transrectal ultrasound (MRI-TRUS) fusion biopsies to their practice. A retrospective review of 1528 patients who had undergone standard systematic TRUS biopsy in addition to fusion TRUS biopsy over nine years at the same institution was conducted. Patients were divided into three chronological groups of three years each. Fusion biopsy and systematic biopsy had comparable cancer detection rates in the first three years. In the subsequent two three-year periods, fusion biopsy detected significantly more clinically significant prostate cancer compared to systematic biopsy. Fusion biopsy also detected significantly less low risk disease in the same time period. As expected, the accuracy of fusion biopsy increases with time but there is a very apparent early learning period that may impede usage of fusion biopsy on its own initially. 

Changes in prostate cancer detection rate of MRI-TRUS fusion vs systematic biopsy over time: evidence of a learning curve.
Calio B, Sidano A, Sugano D, et al.
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Pravisha Ravindra

University Hospitals Leicester NHS Trust.

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