{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:02:20Z","timestamp":1790341340520,"version":"4.1.0"},"reference-count":19,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Objective: To evaluate the incremental yield of clinically significant prostate cancer (csPCa) detected by systematic biopsy outside MRI-targeted lesions during cognitive fusion local anaesthetic transperineal prostate biopsy.\nPatients and methods: This observational cohort study included men undergoing cognitive MRI-targeted prostate biopsy with concurrent systematic sampling. Pre-biopsy MRI findings were recorded using PI-RADS. The primary outcome was csPCa detected exclusively by systematic biopsy outside MRI-targeted lesions despite a negative targeted biopsy. Secondary outcomes included csPCa detection by targeted, systematic, and combined biopsy, PI-RADS subgroup analysis, and multivariable predictors of csPCa.\nResults: Overall, 770 men were included, of whom 767 had evaluable paired biopsy data. Most had PI-RADS 4 lesions (636\/767, 82.9%). csPCa was detected by targeted biopsy in 320\/767 men (41.7%), systematic biopsy outside MRI-targeted lesions in 196\/767 (25.6%), and combined biopsy in 384\/767 (50.1%). Exclusive outside-target systematic csPCa detection occurred in 64\/767 men (8.3%), representing 16.7% of all csPCa detected. This rate was highest in PI-RADS 3 lesions (8\/30, 26.7%). On multivariable analysis, overall csPCa detection was associated with age, PSA density, and PI-RADS score, whereas exclusive outside-target detection was inversely associated with PI-RADS score and positively associated with procedures performed by urologists. Spatial analysis showed that most systematic-only csPCa lesions were anatomically distinct from the index MRI-visible lesion.\nConclusions: Systematic biopsy outside MRI-targeted lesions detected additional csPCa in 64\/767 men (8.3%) and frequently identified anatomically distinct lesions, supporting continued systematic sampling alongside MRI-targeted biopsy in selected patients.<\/jats:p>","DOI":"10.4081\/aiua.2026.15728","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:48:16Z","timestamp":1788774496000},"source":"Crossref","is-referenced-by-count":0,"title":["Incremental detection of clinically significant prostate cancer by systematic biopsy outside MRI-targeted lesions during cognitive fusion local anaesthetic transperineal biopsy"],"prefix":"10.4081","volume":"98","author":[{"given":"Emeka I.","family":"Udeh","sequence":"first","affiliation":[{"name":"Kingston and Richmond Hospital NHS Foundation Trust;\u00a0 Dorset County Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Coull","sequence":"additional","affiliation":[{"name":"Kingston and Richmond Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdussalam","family":"Musbahi","sequence":"additional","affiliation":[{"name":"Kingston and Richmond Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rotimi","family":"David","sequence":"additional","affiliation":[{"name":"Dorset County Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Akiboye","sequence":"additional","affiliation":[{"name":"Epsom and St Helier University Hospitals NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"250115","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-04967-6"},{"key":"250116","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210413"},{"key":"250117","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910038"},{"key":"250118","doi-asserted-by":"publisher","DOI":"10.2147\/RRU.S291963"},{"key":"250119","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32401-1"},{"key":"250120","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801993"},{"key":"250121","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2021.109587"},{"key":"250122","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31070308"},{"key":"250123","unstructured":"9. European Association of Urology. EAU Guidelines on Prostate Cancer - Uroweb n.d. https:\/\/uroweb.org\/guidelines\/prostate-cancer (accessed June 3, 2026)."},{"key":"250124","unstructured":"10. National Institute for Health and Care Excellence. Recommendations | Prostate cancer: diagnosis and management | Guidance | NICE n.d. https:\/\/www.nice.org.uk\/guidance\/ng131\/chapter\/Recommendations#localised-and-locally-advanced-prostatecancer (accessed July 6, 2026)."},{"key":"250125","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-024-00849-5"},{"key":"250126","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012663.pub2"},{"key":"250127","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30569-2"},{"key":"250128","doi-asserted-by":"publisher","DOI":"10.1590\/s1677-5538.ibju.2024.0354"},{"key":"250129","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2022.01.043"},{"key":"250130","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00100-7"},{"key":"250131","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.69380"},{"key":"250132","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2024.07.009"},{"key":"250133","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003492"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15728\/14480","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15728\/14480","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:44:51Z","timestamp":1790340291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/15728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,25]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.15728","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}