Transperineal Prostate Cognitive Fusion Biopsy Prostate's tissue collection for laboratorial analyisis

Prostate biopsy is a procedure in which small fragments of prostate tissue are removed for laboratory analysis. It is the diagnostic procedute that allows for the differential diagnosis between prostate cancer and benign lesions (inflammatory or benign prostatic hyperplasia). Prostate biopsy techniques have undergone recent technological advancements with significant impact on patient outcomes and safety.

The primary advancement has been the integration of multiparametric nuclear magnetic resonance imaging (MRI) to identify suspicious areas in the prostate. This is the most accurate examination in identifying lesions with malignant potential in the prostate and is currently performed prior to any biopsy. The biopsy is conducted with cognitive fusion of these MRI images with real-time transrectal ultrasound images during the procedure. This allows the urologist to biopsy suspicious areas with greater precision, significantly reducing false positives and false negatives, which are common with other classical techniques.

Transperineal biopsy is also an innovative approach, where punctures are performed through the perineal skin (the region between the anus and the scrotum), unlike the classical transrectal biopsy.

Advantages of prostate biopsy with MRI image fusion
- Greater puncture precision: MRI is highly sensitive in detecting suspicious lesions in the prostate. The combination of T2-weighted sequences (high anatomical definition) with diffusion and dynamic post-contrast sequences (physiological information) allows for the identification of clinically significant areas. Lesions in less common prostate zones are also detected, minimizing false-negative results.
- More reliable results: Improved biopsy precision results in fewer inconclusive biopsies and a much lower number of false positives or negatives (common in classical biopsy approaches).
- Reduction of unnecessary biopsies: The increased precision of the results avoids the repetition of unnecessary biopsies due to inconclusive results.

- Improved risk stratification: Image fusion allows for better risk stratification of the disease, guiding the most appropriate therapeutic options for each patient.

Advantages of transperineal prostate biopsy
- Lower risk of infection and complications: The transperineal approach minimizes the risk of infection since the needle does not pass through the rectum, as in conventional transrectal biopsy. The punctures are similar to a simple blood draw and only two skin punctures are required.
- More direct and precise access: This approach offers a more direct angle of access to the gland, allowing for more precise sampling of suspicious areas and the removal of a larger amount of tissue, enabling better analysis by the pathologist.
- Less discomfort: Patients report less discomfort during transperineal biopsy compared to transrectal biopsy. The puncture is performed under local anesthesia, making the procedure more tolerable.

In conclusion, transperineal prostate biopsy with cognitive image fusion is an innovative technique that offers significant advantages over traditional transrectal biopsy. If you are concerned about the possibility of prostate cancer, discuss this biopsy technique with your doctor, which should always be performed by an experienced urologist.