Advances in Prostate Biopsy: From Innovative Imaging Modalities to Optimized Detection Strategies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 1 November 2025 | Viewed by 567

Special Issue Editor


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Guest Editor
1. Department of Urology, Azienda Ospedale-Università Padova, 35122 Padova, Italy
2. Department of Medicine (DIMED), University of Padua, 35128 Padova, Italy
Interests: prostate cancer; biopsy
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Special Issue Information

Dear Colleagues,

(1) Introduction

Prostate cancer remains one of the most prevalent malignancies in men worldwide, and early detection plays a pivotal role in improving patient outcomes. Prostate biopsy is a key diagnostic procedure; however, its practice has been continually refined to enhance accuracy and minimize risks. The advent of advanced imaging modalities, such as PSMA PET, has opened new avenues for the more precise targeting of suspicious lesions. Simultaneously, the debate around systematic versus targeted biopsies challenges traditional protocols. With the growing role of transperineal biopsies and emerging markets for PCa detection technologies, it is imperative to critically appraise the latest evidence and guide future research and clinical practice. This Special Issue aims to provide new insights into the optimization of prostate biopsies, addressing current controversies and exploring cutting-edge advancements. Topics will include the role of imaging-guided biopsies, the benefits and drawbacks of transrectal versus transperineal approaches, the utility of perilesional sampling, and the economic considerations of biopsy protocols. Furthermore, it will delve into emerging technologies in PCa detection and their implications for clinical practice.

We are pleased to invite you to contribute to this Special Issue, which will serve as a platform to consolidate and expand our understanding of prostate biopsy techniques and strategies.

(2) Aim of the Special Issue

This Special Issue aims to explore contemporary advancements and address ongoing challenges in prostate biopsies. Within the journal’s scope, this collection will bring together research and reviews that cover technological innovations, procedural approaches, cost-effectiveness, and clinical implications in prostate cancer detection. With a focus on practical and translational aspects, this Special Issue will provide a comprehensive resource for clinicians, researchers, and industry stakeholders.

(3) Suggested Themes and Article Types

This collection seeks to foster collaboration and discussion among clinicians, researchers, and policymakers, paving the way for evidence-based improvements in prostate biopsy techniques and patient outcomes. Contributions in the form of original research articles and comprehensive reviews are welcome. In this Special Issue, we welcome original research articles, reviews, and case studies in the following areas:

  • The role of PSMA PET and other imaging modalities in prostate biopsies;
  • Systematic biopsies vs. targeted biopsies: pros, cons, and clinical outcomes;
  • The utility and rationale for perilesional biopsies;
  • Comparative analysis of transrectal and transperineal biopsy approaches;
  • Economic evaluations and cost-effectiveness of prostate biopsy protocols;
  • Emerging technologies and markets to improve prostate cancer detection;
  • Patient-centric approaches and minimizing complications in biopsy procedures;
  • Future perspectives and guidelines for prostate biopsy practices.

We look forward to receiving your contributions and working together to create a valuable collection of insights and evidence.

Dr. Fabio Zattoni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate biopsy
  • PSMA PET
  • systematic biopsies
  • targeted biopsies
  • transrectal biopsies
  • transperineal biopsies
  • cost-effectiveness
  • perilesional biopsy
  • PCa detection
  • imaging modalities

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Published Papers (1 paper)

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Research

16 pages, 1312 KiB  
Article
Detection Rates of Prostate Cancer Across Prostatic Zones Using Freehand Single-Access Transperineal Fusion Biopsies
by Filippo Carletti, Giuseppe Reitano, Eleonora Martina Toffoletto, Arianna Tumminello, Elisa Tonet, Giovanni Basso, Martina Bruniera, Anna Cacco, Elena Rebaudengo, Giorgio Saggionetto, Giovanni Betto, Giacomo Novara, Fabrizio Dal Moro and Fabio Zattoni
Cancers 2025, 17(13), 2206; https://doi.org/10.3390/cancers17132206 - 30 Jun 2025
Viewed by 366
Abstract
Background/Objectives: It remains unclear whether certain areas of the prostate are more difficult to accurately sample using MRI/US-fusion-guided freehand single-access transperineal prostate biopsy (FSA-TP). The aim of this study was to evaluate the detection rates of clinically significant (cs) and clinically insignificant [...] Read more.
Background/Objectives: It remains unclear whether certain areas of the prostate are more difficult to accurately sample using MRI/US-fusion-guided freehand single-access transperineal prostate biopsy (FSA-TP). The aim of this study was to evaluate the detection rates of clinically significant (cs) and clinically insignificant (ci) prostate cancer (PCa) in each prostate zone during FSA-TP MRI-target biopsies (MRI-TBs) and systematic biopsies (SB). Methods: This monocentric observational study included a cohort of 277 patients with no prior history of PCa who underwent 3 MRI-TB cores and 14 SB cores with an FSA-TP from January to December 2023. The intraclass correlation coefficient (ICC) was assessed to evaluate the correlation between the Prostate Imaging–Reporting and Data System (PI-RADS) of the index lesion and the International Society of Urological Pathology (ISUP) grade stratified according to prostate zone and region of index lesion at MRI. Multivariate logistic regression analysis was conducted to identify factors associated with PCa and csPCa in patients with discordant results between MRI-TB and SB. Results: FSA-TP-MRI-TB demonstrated higher detection rates of both ciPCa and csPCa in the anterior, apical, and intermediate zones when each of the three MRI-TB cores was analysed separately (p < 0.01). However, when all MRI-TB cores were combined, no significant differences were observed in detection rates across prostate zones (apex, mid, base; p = 0.57) or regions (anterior vs. posterior; p = 0.34). Concordance between radiologic and histopathologic findings, as measured by the intraclass correlation coefficient (ICC), was similar across all zones (apex ICC: 0.33; mid ICC: 0.34; base ICC: 0.38) and regions (anterior ICC: 0.42; posterior ICC: 0.26). Univariate analysis showed that in patients with PCa detected on SB but with negative MRI-TB, older age was the only significant predictor (p = 0.04). Multivariate analysis revealed that patients with PCa detected on MRI-TB but with negative SB, only PSA remained a significant predictor (OR 1.2, 95% CI 1.1–1.4; p = 0.01). In cases with csPCa detected on MRI-TB but with negative SB, age (OR: 1.0, 95% CI 1.0–1.1; p = 0.02), positive digital rectal examination (OR: 2.0, 95% CI 1.1–3.8; p = 0.03), PI-RADS score >3 (OR: 4.5, 95% CI 1.7–12.1; p < 0.01), and larger lesion size (OR: 1.1, 95% CI 1.1–1.2; p < 0.01) were significant predictors. Conclusions: FSA-TP using 14 SB cores and 3 MRI-TB cores ensures comprehensive sampling of all prostate regions, including anterior and apical zones, without significant differences in detection rates between nodules across different zones. Only in a small percentage of patients was csPCa detected exclusively by SB, highlighting the small but important complementary value of combining SB and MRI-TB. Full article
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