MRI In-Bore Biopsy Superior to Fusion for Small PI-RADS 4 Lesions

In a retrospective study of 308 small PI-RADS 4 prostate lesions (≤7 mm) in biopsy-naïve patients, in-bore MRI-guided biopsy yielded higher clinically significant cancer detection (41.9%) than software fusion (20.6%).

• Retrospective comparison of 268 patients (148 lesions with in-bore, 160 with fusion).
• Overall cancer detection was 54.9% any prostate cancer, 30.8% clinically significant (csPC). In-bore technique was an independent predictor of csPC (p<0.001).
• Limitations: single-center, non-randomized, and retrospective design with potential selection bias.

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