Multiparametric MRI/TRUS Fusion Biopsy, Outcomes, and Commercial Systems

The nontargeted systematic sampling of 12-core (10–14 cores per guidelines) transrectal ultrasound (TRUS) guided biopsy has resulted in considerable undergrading of clinically significant prostate cancers (csPCa). Magnetic resonance imaging (MRI)/TRUS fusion-guided biopsy has emerged as an option for improved detection of csPCa. This technology, which combines high-resolution anatomic and functional prostate imaging via multiparametric MRI with real-time TRUS biopsy probe guidance, allows for precise targeted biopsies of MRI-specified lesions within the prostate suspicious for harboring cancer. As multiple studies have illustrated now, this biopsy method has revolutionized the way prostate cancer screening, risk stratification, and treatment decision-making take place. Herein, we provide a review of the MRI/TRUS fusion biopsy technique, an overview of the currently available fusion biopsy platforms, and reports of their clinical operational outcomes.