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@ARTICLE{AlMonajjed:305749,
      author       = {R. Al-Monajjed$^*$ and M. Boschheidgen and J. Lakes and A.
                      Krilaviciute$^*$ and J.-P. Radtke$^*$ and H.-P.
                      Schlemmer$^*$ and D. Bonekamp$^*$ and K. Herkommer and M.
                      Jahnen and J. E. Gschwend and D. Düx and F. Wacker and M.
                      R. Makowski and A. Sauter and M. A. Kuczyk and N. Harke and
                      J. Debus and C. Grott and C. Arsov and P. Seibold$^*$ and A.
                      Benner$^*$ and B. Hadaschik$^*$ and F. Giesel and G.
                      Kristiansen and G. Antoch and N. Becker$^*$ and R. Kaaks$^*$
                      and P. Albers$^*$ and L. Schimmöller},
      title        = {{V}alue of {A}dditional {S}ystematic {C}ores {D}uring
                      {M}agnetic {R}esonance {I}maging-guided {T}argeted {B}iopsy
                      in {P}rostate {C}ancer {S}creening for {Y}oung {M}en:
                      {R}esults from the {PROBASE} {T}rial.},
      journal      = {European urology oncology},
      volume       = {nn},
      issn         = {2588-9311},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-02369},
      pages        = {nn},
      year         = {2025},
      note         = {#EA:C130#LA:C130# / epub},
      abstract     = {While magnetic resonance imaging (MRI)-guided targeted
                      biopsy (TBx) is becoming an integral part of early detection
                      of prostate cancer (PC), its role in screening of younger
                      men remains unclear. We analyzed the additional value of
                      systematic biopsy (SBx) in improving detection of clinically
                      significant PC (csPC).A total of 525 men aged 45-54 yr with
                      confirmed prostate-specific antigen ≥3.0 ng/ml underwent
                      multiparametric MRI followed by combined TBx and SBx between
                      February 2014 and August 2023 within a multicenter
                      prospective screening trial in Germany. Software-based
                      MRI/ultrasound fusion TBx (2 cores per lesion) combined with
                      SBx was performed via a transrectal or transperineal
                      approach. The primary objective was to analyze differences
                      in csPC detection rates between SBx and TBx in relation to
                      MRI. Secondary objectives were detection rates by
                      International Society of Urological Pathology grade group
                      (GG) and the distribution of SBx and/or TBx findings.PC was
                      detected in 209 men $(39\%),$ of which 148/209 cases were
                      csPC $(71\%;$ GG ≥2). SBx missed 24/148 csPC cases
                      $(16\%)$ and TBx missed 49/148 $(33\%).$ SBx detected 25
                      more low-risk PC cases than TBx (51 vs 26). For $64\%$ of
                      the cases in which SBx detected higher GG than TBx (n = 89,
                      including GG 1), the positive cores were located within
                      MRI-detected lesions. Five GG ≥3 PC cases were not
                      identified on MRI. Limitations include the lack of
                      centralized MRI review before biopsy, variability in biopsy
                      technique, retrospective subgroup analysis, and short
                      follow-up.A relevant proportion of csPC cases were missed by
                      two-core TBx, although they were correctly identified on
                      MRI, suggesting limitations in targeting accuracy and/or the
                      fusion technique. SBx cores or targeted perilesional
                      sampling, particularly in young men with smaller prostate
                      volume, might be a valuable complement to TBx to ensure
                      reliable and early detection of (cs)PC in this age group.We
                      looked at the effectiveness of systematic biopsy (usually 12
                      cores taken from the prostate gland) and targeted biopsy
                      (cores from a suspicious area seen on a scan) of the
                      prostate among men aged 45-54 years as part of a prostate
                      cancer screening trial. The results show that using only two
                      targeted cores per lesion seen on an MRI (magnetic resonance
                      imaging) scan may miss a significant number of clinically
                      relevant prostate cancers. One reason could be that
                      MRI-targeted biopsies are not always perfectly accurate. To
                      improve diagnostic accuracy in younger men, it may be
                      necessary to take additional systematic tissue samples, or
                      at least more samples from around any suspicious area. This
                      trial is registered on ISRCTN as ISRCTN37591328.},
      keywords     = {Fusion biopsy (Other) / Magnetic resonance imaging (Other)
                      / Prostate cancer (Other) / Prostate-specific antigen
                      (Other) / Risk-adapted screening (Other) / Ultrasound
                      (Other)},
      cin          = {C130 / E010 / C060 / ED01 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C130-20160331 / I:(DE-He78)E010-20160331 /
                      I:(DE-He78)C060-20160331 / I:(DE-He78)ED01-20160331 /
                      I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41219113},
      doi          = {10.1016/j.euo.2025.10.014},
      url          = {https://inrepo02.dkfz.de/record/305749},
}