Detection of Clinically Significant Prostate Cancer Using Micro-Ultrasound Versus MRI/Ultrasound Fusion Biopsy: A Propensity-Weighted Comparative Study

No AccessJournal of UrologyOriginal Clinical Article26 Sep 2025Detection of Clinically Significant Prostate Cancer Using Micro-Ultrasound Versus MRI/Ultrasound Fusion Biopsy: A Propensity-Weighted Comparative Study Rafael Castilho Borges, Rafael Rocha Tourinho-Barbosa, Nuno Dias, Gustavo de Barros Pena Ribeiro Paiva, Sidney Glina, Oliver Rojas Claros, Lara Rodriguéz Sanchéz, François Rozet, Eric Barret, Yann Pierre Barbé, Camille Lanz, Rafael Sanchez-Salas, Xavier Cathelineau, Petr Macek, and Fernando Korkes Rafael Castilho BorgesRafael Castilho Borges Corresponding Author: Rafael Castilho Borges, MD Department of Urology, Institut Mutualiste Montsouris. Address: 42, Boulevard Jourdan – 75674, Paris, France. Phone: +33-1-56-61-62-63 E-mail: (email protected) https://orcid.org/0000-0001-9868-1067 , Rafael Rocha Tourinho-BarbosaRafael Rocha Tourinho-Barbosa Instituto D'Or de Pesquisa e Ensino (IDOR) - Salvador, Brazil , Nuno DiasNuno Dias Department of Urology, Institut Mutualiste Montsouris, Paris, France , Gustavo de Barros Pena Ribeiro PaivaGustavo de Barros Pena Ribeiro Paiva Department of Urology, Institut Mutualiste Montsouris, Paris, France , Sidney GlinaSidney Glina Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil , Oliver Rojas ClarosOliver Rojas Claros Hospital Israelita Albert Einstein, Department of Urology, São Paulo, Brazil , Lara Rodriguéz SanchézLara Rodriguéz Sanchéz Department of Urology, Institut Mutualiste Montsouris, Paris, France , François RozetFrançois Rozet Department of Urology, Institut Mutualiste Montsouris, Paris, France , Eric BarretEric Barret Department of Urology, Institut Mutualiste Montsouris, Paris, France , Yann Pierre BarbéYann Pierre Barbé Department of Urology, Institut Mutualiste Montsouris, Paris, France , Camille LanzCamille Lanz Department of Urology, Institut Mutualiste Montsouris, Paris, France , Rafael Sanchez-SalasRafael Sanchez-Salas Department of Urology, Mc Gill University, Montreal, Canada , Xavier CathelineauXavier Cathelineau Department of Urology, Institut Mutualiste Montsouris, Paris, France , Petr MacekPetr Macek Department of Urology, Institut Mutualiste Montsouris, Paris, France , and Fernando KorkesFernando Korkes Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil View All Author Informationhttps://doi.org/10.1097/JU.0000000000004793AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: To compare the detection rates of clinically significant prostate cancer (csPCa) between cognitively targeted micro-ultrasound-guided biopsy (MB) and MRI/ultrasound fusion-guided biopsy (PFB) in men with MRI-visible lesions. Methods: We retrospectively analyzed 1,119 men who underwent MB (n=767) or PFB (n=352) between 2019 and 2022. Inverse probability of treatment weighting (IPTW) based on a logistic regression propensity score was applied to balance baseline characteristics between groups. Weighted logistic regression models were used to compare csPCa detection in the overall cohort and in subgroups of biopsy-naïve men and those with anterior lesions. A separate multivariable logistic regression was performed in the full cohort to identify independent predictors of csPCa. Concordance between biopsy and radical prostatectomy Gleason scores was also evaluated. Results: After IPTW adjustment, csPCa detection with MB was higher than with PFB in combined sampling (45% vs. 34%; OR 1.61; 95% CI 1.23–2.11; p<0.01). However, no significant difference was observed between techniques for targeted biopsies alone, both in the overall cohort and among biopsy-naïve men. In patients with anterior lesions, csPCa detection rates were also similar. In the full cohort multivariable model, MB and PIRADS 5 lesions were independently associated with csPCa. Gleason upgrading at prostatectomy was more frequent in the PFB group (38% vs. 17%; p=0.01). Conclusion: While MB demonstrated higher csPCa detection in adjusted analyses, the benefit was not consistent across all settings. Further studies are warranted to determine whether this reflects a methodological advantage or context-dependent factors. © 2025 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2025 by American Urological Association Education and Research, Inc.Keywordsbiopsydetectionmagnetic resonance imagingprostate cancerultrasound Author Information Rafael Castilho Borges Corresponding Author: Rafael Castilho Borges, MD Department of Urology, Institut Mutualiste Montsouris. Address: 42, Boulevard Jourdan – 75674, Paris, France. Phone: +33-1-56-61-62-63 E-mail: (email protected) More articles by this author Rafael Rocha Tourinho-Barbosa Instituto D'Or de Pesquisa e Ensino (IDOR) - Salvador, Brazil More articles by this author Nuno Dias Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Gustavo de Barros Pena Ribeiro Paiva Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Sidney Glina Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil More articles by this author Oliver Rojas Claros Hospital Israelita Albert Einstein, Department of Urology, São Paulo, Brazil More articles by this author Lara Rodriguéz Sanchéz Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author François Rozet Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Eric Barret Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Yann Pierre Barbé Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Camille Lanz Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Rafael Sanchez-Salas Department of Urology, Mc Gill University, Montreal, Canada More articles by this author Xavier Cathelineau Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Petr Macek Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Fernando Korkes Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil More articles by this author Expand All Advertisement PDF downloadLoading ...