{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:18:07Z","timestamp":1770815887734,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prostate cancer (PCa) diagnosis and staging have evolved with the advent of 68Ga\u2010Prostate\u2010specific membrane antigen positron emission tomography\/computed tomography (PSMA\u2010PET\/CT). This study investigates the role of complementary systematic biopsies (SB) during PSMA\u2010PET\/CT\u2010guided targeted prostate biopsies (PET\u2010TB) for PCa detection, grading, and distribution. We address the uncertainty surrounding the necessity of SB in conjunction with PET\u2010TB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed PCa grading and distribution in 30 men who underwent PET\u2010TB and SB because of contraindication to magnetic resonance imaging or high clinical suspicion of PCa. Tumor distribution was assessed in relation to the PET\u2010highlighted lesions. Standardized reporting schemes, encompassing SUV<jats:sub>max<\/jats:sub>, PRIMARY score, and miTNM classification, were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>80% of patients were diagnosed with PCa, with 70% classified as clinically significant (csPCa). SB detected more csPCa cases than PET\u2010TB, but the differences were not statistically significant. Discordant results were observed in 25% of cases, where SB outperformed PET\u2010TB. Spatial analysis revealed that tumor\u2010bearing cores from SB were often located in close proximity to the PET\u2010highlighted region. Reporting schemes showed potential for csPCa detection with significantly increased SUV<jats:sub>max<\/jats:sub> in csPCA patients. Subsequent follow\u2010up data underscored the importance of SB in precise PCa grading and staging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While PET\u2010TB can simplify prostate biopsy and reduce invasiveness by core number, SB cannot be omitted yet due to potential PET\u2010TB targeting errors. Factors such as limited spatial resolution and fusion inaccuracies contribute to the need for SB. Standardization in reporting schemes currently cannot compensate for targeting errors highlighting the need for refinement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24694","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T07:44:03Z","timestamp":1710920643000},"page":"772-779","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Key learnings from concordant systematic biopsies in prostate\u2010specific membrane antigen positron emission tomography\/computed tomography\u2010guided prostate biopsies: Enhancing targeting accuracy"],"prefix":"10.1002","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0316-9621","authenticated-orcid":false,"given":"Thomas","family":"B\u00fcttner","sequence":"first","affiliation":[{"name":"Department of Urology and Paediatric Urology University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"G\u00e4rtner","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Essler","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Weiten","sequence":"additional","affiliation":[{"name":"Department of Urology and Paediatric Urology University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen","family":"Kristiansen","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-0857","authenticated-orcid":false,"given":"J\u00f6rg","family":"Ellinger","sequence":"additional","affiliation":[{"name":"Department of Urology and Paediatric Urology University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Ritter","sequence":"additional","affiliation":[{"name":"Department of Urology and Paediatric Urology University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8213-9975","authenticated-orcid":false,"given":"Philipp","family":"Krausewitz","sequence":"additional","affiliation":[{"name":"Department of Urology and Paediatric Urology University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"key":"e_1_2_10_2_1","article-title":"Clinical trial protocol for PRIMARY2: a multicentre, phase 3, randomised controlled trial investigating the additive diagnostic value of [68Ga]Ga\u2010PSMA\u201011 Positron Emission Tomography\/Computed Tomography in men with negative or equivocal multiparametric magnetic resonance imaging for the diagnosis of clinically significant prostate cancer","author":"Buteau JP","year":"2023","journal-title":"Eur. 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