• David Gómez-Ortiz, Adrián M Garza-Gangemi, Mariano Oropeza-Aguilar, Sergio Rangel-Suárez, Verónica Espinosa-Cruz, Antonio C Villegas-Hernández, Ricardo Martínez-Martínez, and Ricardo A Castillejos-Molina.
• Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
• Rev Invest Clin. 2022 Jul 1; 74 (4): 212-218.

BackgroundMultiparametric magnetic resonance imaging improves the performance of prostate cancer (PCa) diagnostics through a better selection of patients.ObjectivesThe aim of the study was to study the detection rate (DR) of systematic and targeted cognitive biopsies in a cohort with the previous negative systematic biopsies. A secondary objective was to describe the value of prostate-specific antigen density (PSAd) in the detection of clinically significant PCa (CSPCa).MethodsWe designed a prospective, single-center, and comparative study to determine the DR of systematic and targeted cognitive biopsies. The clinical and pathological characteristics of each patient were described.ResultsA total of 111 patients with Prostate Imaging Reporting and Data System lesions > 3 were included in the study. PCa was detected in 41.4% (46 of 111 patients); 42 (91.3%) were detected by systematic biopsy and 30 (65.2%) by targeted biopsy. CSPCa was detected in 26 (23.4%), 23 (88.5%) by systematic biopsy, and 21 (76.9%) by targeted biopsy. PSAd > 0.15 was directly associated with CSPCa.ConclusionThe detection of PCa by systematic biopsy in this series was higher than 80%; hence, its routine use should not be replaced by targeted biopsy, since it continues to be the cornerstone of the diagnosis in patients with prior negative biopsies.

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