Multidisciplinary Approach in MR-US Fusion Prostate Biopsy: Does Real-Time Radiologist Assistance Associate With Reduced Overdiagnosis and Improved Name Surname1* Name Surname2 Name Surname2 Detection in 'Challenging' (PI-RADS 3-4) Lesions? N S me3 N S (A Propensity Score-Matched Analysis)

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dc.contributor.authorOzel, Mehmet Ali
dc.contributor.authorBaba, Dursun
dc.contributor.authorNaldemir, Ibrahim Feyyaz
dc.contributor.authorGurpinarli, Burak Mehmet
dc.contributor.authorAyvacik, Burak
dc.date.accessioned2026-07-01T11:39:29Z
dc.date.available2026-07-01T11:39:29Z
dc.date.issued2026
dc.departmentDüzce Üniversitesi
dc.description.abstractAim: To evaluate the impact of real-time radiologist assistance on the detection rates of clinically significant prostate cancer (csPCa) and the reduction of overdiagnosis in patients with challenging lesions (PI-RADS 3 and 4), using a propensity score-matched analysis. Material and Methods: We retrospectively analyzed patients who underwent softwarebased MR-US fusion biopsy for PI-RADS 3 or 4 lesions. PI-RADS 5 lesions were excluded to better assess operator-dependent targeting. Patients were stratified into two cohorts: the Multidisciplinary Group (MDG), with active real-time radiologist assistance, and the Single-Operator Group (SOG), performed by the urologist alone. To minimize selection bias, 1:3 propensity score matching (PSM) was conducted based on age, PSA level, prostate volume, and index lesion size. Results: Following matching, 98 patients (28 MDG, 70 SOG) were included. Overall cancer detection rate (CDR) was numerically higher in the SOG (67.1% vs. 53.6%), largely driven by a numerically higher detection of insignificant (ISUP Grade Group 1) cancers (41.4% vs. 21.5%). Conversely, csPCa detection (ISUP >= 2) was higher in the MDG (32.1% vs. 25.7%). First-strike success (detection in the first core) was 88.9% in the MDG vs. 75.0% in the SOG. Subgroup analyses showed a strong clinical trend toward superior csPCa detection in the MDG for anterior lesions (60.0% vs. 23.3%, p=0.053). Conclusion: In PI-RADS 3-4 lesions, the single-operator approach yields high sensitivity but may carry a risk of overdiagnosis. Real-time radiologist assistance appears to refine diagnostic yield by increasing csPCa detection while minimizing insignificant findings, particularly in challenging anatomical locations.
dc.identifier.doi10.18521/ktd.1838273
dc.identifier.endpage61
dc.identifier.issn1309-3878
dc.identifier.issue1
dc.identifier.startpage56
dc.identifier.urihttps://doi.org/10.18521/ktd.1838273
dc.identifier.urihttps://hdl.handle.net/20.500.12684/23326
dc.identifier.volume18
dc.identifier.wosWOS:001730411100009
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.language.isoen
dc.publisherDuzce Univ, Fac Medicine
dc.relation.ispartofKonuralp Tip Dergisi
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260623
dc.subject[Keyword Not Available]
dc.titleMultidisciplinary Approach in MR-US Fusion Prostate Biopsy: Does Real-Time Radiologist Assistance Associate With Reduced Overdiagnosis and Improved Name Surname1* Name Surname2 Name Surname2 Detection in 'Challenging' (PI-RADS 3-4) Lesions? N S me3 N S (A Propensity Score-Matched Analysis)
dc.typeArticle

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