{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:43:55Z","timestamp":1755798235279,"version":"3.44.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To evaluate unilateral systematic biopsy (SB) combined with targeted biopsy (TB) and assess its diagnostic accuracy in a real-world, single-centre setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with \u22651 MRI lesion who underwent both transperineal 12-core and 3-core TB were enrolled in this study. Detection rates for total prostate cancer (PCa) and clinically significant PCa (csPCa) were compared between TB, unilateral SB+TB, and SB+TB. Pathological consistency was assessed using the kappa test, and logistic regression was used to identify potential predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 250 men were enrolled, of which 126 (50.4%) and 103 (41.2%) exhibited total PCa and csPCa, respectively. Compared to SB+TB, ipsilateral SB combined with TB (ips-SB+TB) had a comparable csPCa detection rate (99\/250 vs 103\/250, p=0.125), while fewer clinically insignificant PCa were detected (17\/250 vs 23\/250, p=0.031). In addition, ips-SB+TB demonstrated superior sensitivity for csPCa (96.1%) with an AUC of 0.98. The ips-SB+TB had a significantly higher positive core rate than SB+TB (472\/2244 vs. 563\/3744, p&amp;lt;0.001). Moreover, ips-SB+TB also had a high consistency of Gleason grade compared to SB+TB (Kappa=0.89). In the multi-lesion cohort, ips-SB+TB also had a comparable csPCa detection rate compared to SB+TB (63\/128 vs. 67\/128, p=0.125).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In conclusion, our study showed that ips-SB+TB was comparable to SB+TB in detecting csPCa. The results of this study provide valuable insight into the potential of ips-SB+TB as an alternative to SB+TB.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1599869","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T04:10:37Z","timestamp":1755576637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the diagnostic accuracy of unilateral systematic biopsy combined with targeted 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