Outcomes of Transperineal MRI-Fusion Targeted Prostate Biopsy Utilizing PrecisionPoint versus a Grid Template
Dylan Buller, MD1, Maria Anthony, BS2, Stuart Kesler, MD3, Ilene Staff, PhD3, Tara McLaughlin, PhD3, Joseph Tortora, MS3, Kevin Pinto, BS3, Joseph Wagner, MD3.
1UConn Health, Farmington, CT, USA, 2University of Connecticut School of Medicine, Farmington, CT, USA, 3Hartford Hospital, Hartford, CT, USA.
BACKGROUND: Urologists are increasingly performing prostate biopsies (PBx) via a transperineal (TP) approach. The two predominant methods for performing TP PBx employ either a grid template (G) or a more freehand approach, often with devices such as PrecisionPoint® (PP). As existing data are sparse, our objective was to compare the two techniques on rates of clinically significant prostate cancer (csPCa) detection and complications when MRIfusion targeted (MRI) PBx is performed.
METHODS: We queried a prospectively maintained prostate biopsy database to identify men ages 18-89 who underwent TP MRI-PBx (including concurrent systematic PBx) between 8/1/20 and 9/30/22. G-MRI-PBx were performed until 4/1/22, and PP-MRI-PBx were performed subsequently. All PBx were performed using UroNav software. The primary outcome was detection of csPCa in the MRI region of interest (ROI). 30 day complications and overall rates of csPCa were examined at the patient level. Subgroup outcomes included csPCa detection in anterior MRI ROIs (as anterior ROIs can be challenging to access due to pubic bone interference) and stratification by prior PBx status. csPCa was defined as Grade Group ≥2. RESULTS: 551 MRI ROIs in 452 patients were included in the analysis. Prior biopsy status differed between groups (Table 1); however, when stratified by prior biopsy status, there was no difference in csPCa detection found between a grid or PP approach (Table 2). PP-MRI-PBx and G-MRI-PBx had similar overall and ROI csPCa detection rates (Table 2). Complication rates and the ability to detect csPCa in anterior ROIs was similar between the two groups (Table 2). CONCLUSIONS: G-MRI-PBx and PP-MRI-PBx identified similar rates of csPCa, including in anterior MRI lesions and when stratified by prior biopsy status. Complication rates were low and did not differ based on biopsy technique. 
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