{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:52:00Z","timestamp":1791341520622,"version":"4.3.1"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rapid global adoption of ultrasound\u2010guided transperineal prostate biopsy has been accompanied by inconsistent nomenclature, particularly surrounding the term \u201cfreehand.\u201d This lexical imprecision creates confusion in the scientific literature, limits comparability across studies, and complicates clinical communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To clarify the historical and current use of terminology in ultrasound\u2010guided prostate biopsy and to propose a simplified, standardized classification system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed the historical evolution of ultrasound\u2010guided biopsy techniques, focusing on the original definition of \u201cfreehand\u201d and its subsequent misuse in contemporary practice. We examined the technical distinctions between guideless biopsy, probe\u2010mounted needle guides, and template\/grid\u2010based systems, including the role of stepper devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The term \u201cfreehand\u201d was originally introduced to describe a guideless technique and should not be applied to procedures using a mechanical needle guide attached to the ultrasound transducer. The growing proliferation of expressions such as \u201cfull freehand,\u201d \u201cpure freehand,\u201d \u201ctotally freehand,\u201d and \u201cdouble freehand\u201d does not resolve the underlying ambiguity. We further argue that a stepper used only to stabilize the ultrasound probe, without a needle\u2010guiding grid, does not alter the freehand nature of needle manipulation. To reduce ambiguity, we propose a three\u2010tier classification: (1) Template\/Grid, (2) Probe\u2010Mounted Guide, and (3) Freehand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Standardized terminology is essential for accurate scientific reporting, meaningful comparison of outcomes, and effective clinical communication. Adoption of a simplified classification system may improve clarity across future studies and practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70170","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T18:30:58Z","timestamp":1775673058000},"page":"975-981","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Challenging the Evolving Nomenclature of Ultrasound\u2010Guided Transperineal Prostate Biopsy: A Call for Standardization"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3812-0430","authenticated-orcid":false,"given":"Pedro Ivo C.","family":"Ravizzini","sequence":"first","affiliation":[{"name":"Department of Urology Irmandade da Santa Casa de Misericordia de S\u00e3o Paulo  Brazil"},{"name":"Department of Radiology Division of Interventional Radiology, Irmandade da Santa Casa de Misericordia de S\u00e3o Paulo  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Fernando","family":"Delmonte","sequence":"additional","affiliation":[{"name":"Department of Radiology Division of Interventional Radiology, Irmandade da Santa Casa de Misericordia de S\u00e3o Paulo  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Arthur G.","family":"Valdo","sequence":"additional","affiliation":[{"name":"Department of Radiology Division of Interventional Radiology, Irmandade da Santa Casa de Misericordia de S\u00e3o Paulo  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Rangel","sequence":"additional","affiliation":[{"name":"Department of Radiology Division of Interventional Radiology, Irmandade da Santa Casa de Misericordia de S\u00e3o Paulo  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roni C.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Urology Irmandade da Santa Casa de Misericordia de S\u00e3o Paulo  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562872221100590"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2019.12.40"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-022-00684-0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00100-7"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12301-025-00522-w"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bco2.178"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.32604\/cju.2025.067507"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16204"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12860"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-023-03705-y"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/iju.iju_423_24"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-39451-4"},{"key":"e_1_2_10_14_1","first-page":"1","volume-title":"Interventional 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