Clinical value of transperineal prostate biopsy guided by cognitive fusion of magnetic resonance and transrectal ultrasound.

This study assesses the clinical value of magnetic resonance imaging (MRI) and transrectal ultrasonography (TRUS) cognitive fusion-guided transperineal prostate biopsy for prostate cancer detection. A total of 110 patients with suspected prostate cancer admitted from June 2019 to June 2021 were included. All patients underwent systematic TRUS-guided biopsy and MRI-TRUS cognitive fusion-guided transperineal biopsy. The prostate cancer detection rate, distribution at different total prostate specific antigen levels and risk levels, and postoperative complication incidence were analyzed. Of 110 patients, 63 were confirmed with prostate cancer. The MRI-TRUS fusion-guided biopsy achieved a higher positive detection rate (54.55%) than systematic puncture biopsy (51.82%), although the difference was not statistically significant (P > .05). There was no significant difference in positive rates across total prostate specific antigen levels (<4, 4-10, 10-20, 20-50 ng/mL) or among Gleason score-based risk groups (P > .05). Using systematic puncture biopsy as the gold standard, MRI-TRUS fusion-guided biopsy showed an accuracy of 79.09%, sensitivity of 79.64%, specificity of 79.61%, positive predictive value of 72.49%, and negative predictive value of 86.91%. Complications, including hematuria, bloody stool, fever, and dysuria, were mild, managed with antibiotics, catheterization, and rehydration, with no significant difference in complication rates (P > .05). MRI-TRUS fusion-guided transperineal prostate biopsy demonstrates higher detection efficiency, reduces needle use, minimizes postoperative complications, and offers improved safety compared to systematic puncture biopsy.