- Design
- Non-randomised comparative study
- Population
- 108 men with PI-RADS ≥3 lesions on mpMRI
- Primary outcome
- Detection of clinically significant prostate cancer (Grade Group ≥2)
- Effect
- 72.1% vs 56.9%; OR 0.51 (0.22–1.17), p = 0.11
This Indian comparative study included 108 men with a PI-RADS 3 or higher lesion on mpMRI. Sixty-five had four targeted cores per lesion plus a 12-core systematic biopsy; 43 had targeted saturation biopsy — four targeted plus four perilesional cores — plus the systematic biopsy.
Clinically significant cancer (Grade Group 2 or above) was found in 72.1% with saturation biopsy against 56.9% with standard targeted biopsy (p = 0.11; OR 0.51, 95% CI 0.22–1.17). Complication rates were similar.
The difference is not statistically significant, the groups were not randomised and baseline characteristics were unbalanced. The idea — that cancer extends beyond the visible lesion — is supported by other work, but this study cannot confirm a benefit.
- Adding perilesional cores did not significantly improve detection in this study.
- Groups were not randomised and baseline features differed, limiting conclusions.
- Perilesional sampling may be considered where MRI-biopsy registration is uncertain.
- Complication rates were similar with the extra cores.
Why it matters
Missed significant cancer at the lesion margin is a recognised failure of targeted biopsy.
Don't overread it
Non-randomised, small, and not statistically significant.
The statistics, in plain English
A p-value of 0.11 and an odds ratio interval from 0.22 to 1.17 that crosses 1 mean the difference could be due to chance.
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