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First page of Conventional cognitive freehand versus software-supported, volumetric-optimized systematic ultrasound-guided prostate biopsy: a head-to-head comparison

Introduction Routine systematic prostate biopsy still is recommended beside targeted biopsies, since without, a significant proportion of prostate cancer (PCa) will be missed. Out of the various methods we investigated two in a head-to-head comparison: the volumetric-optimized software supported (VOT) and the conventional cognitive freehand (CFT) ultrasound-guided systematic prostate biopsy. Methods This is a retrospective analysis within a consecutive cohort of men undergoing prostate biopsy between 2014 and 2023. Baseline characteristics, diagnostic performance in detecting PCa with corresponding relative risks have been assessed. Results 573 patients have been included into analysis; 135 in the CFT and 438 in the VOT group. In the CFT-group, 25(18.5%) showed positive with significant PCa(defined as Gleason Score ≥7), in the VOT-group 125(28.5%), respectively. The relative risk for the diagnosis of significant cancer was statistically significant higher in the VOT compared to the CFT group with a relative risk of 1.54 (95% CI from 1.05 to 2.26), whereas the relative risk for insignificant cancer was almost identical. Conclusion Our results showed that VOT has better diagnostic performance than CFT in detecting significant prostate cancer (defined as Gleason Score ≥7). Taking the study limitations into consideration, the corroboration of our results in other cohorts would promote their generalizability.

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Research Article
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S. Karger AG, Basel
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2025
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