Comparison of TB+PB and TB+6SB for Prostate Cancer Diagnosis

Summary

The goal of this randomized controlled trial (RCT) is to evaluate the diagnostic efficacy of two novel prostate biopsy schemes, including targeted and perilesional biopsy (TB+PB) and combination of sextant-systematic biopsy and targeted biopsy (TB+6SB).

The main questions it aims to answer are:

Does TB+PB promote the accurate diagnosis of clinically significant prostate cancer (csPCa)? Could TB+6SB achieve the non-inferior diagnostic efficacy compared to TB+PB scheme? What's the value of TB+6SB in improving the detection of prostate cancer in the negative prostate lobe (contralateral to the index lesion)? In the era of MRI-targeted biopsy (TB), when TB and PB is effectively conducted and allows confident detection of the ROI, do we still need to perform SB? Researchers will compare the cancer detection rates of TB+PB and TB+SB to explore the efficacy of different prostate biopsy schemes. They will evaluate the diagnostic profile of different prostate biopsy schemes through the spatial analysis of the prostate.

Participants will:

Receive TB+PB or TB+6SB.

Conditions

• Prostate Cancer (Diagnosis)

Interventions

PROCEDURE

TB+PB

The biopsy procedure was conducted by a highly skilled and experienced urologist who specializes in performing prostate biopsies. Prophylactic antibiotics were routinely used both before and one day prior to scheduled surgery. Each patient was placed in the left lateral position or lithotomy position. The ultrasound equipment used included a color Doppler ultrasound diagnostic instrument (Hitachi HiVision, Philips Epiq 7), transrectal probes, and corresponding puncture needle guns. Color Doppler examination was performed from the base to the apex. For patients in the TB+PB group, three-core TB was obtained within the predefined MRI suspicious lesion (ROI), followed by ring-distributed 6-core PB within a 10 to 15 mm radius around the ROI. The location of these nine cores depended on the shape and location of the suspicious lesion. Each core was placed in an individual container and reported separately in accordance with the Ginsburg scheme.

PROCEDURE

TB+6SB

The biopsy procedure was conducted by a highly skilled and experienced urologist who specializes in performing prostate biopsies. Prophylactic antibiotics were routinely used both before and one day prior to scheduled surgery. Each patient was placed in the left lateral position or lithotomy position. The ultrasound equipment used included a color Doppler ultrasound diagnostic instrument (Hitachi HiVision, Philips Epiq 7), transrectal probes, and corresponding puncture needle guns. Color Doppler examination was performed from the base to the apex. For patients in the TB+6SB group, three-core TB within the predefined mpMRI index lesion (ROI) was firstly performed. Then patients received six-core sextant-SB bilaterally with each side two cores in the peripheral zone and one core in the transitional zone. Each core was placed in an individual container and reported separately in accordance with the Ginsburg scheme.

Sponsors & Collaborators

• Peking University First Hospital

  lead OTHER

Principal Investigators

• Yi Liu · Peking University First Hospital

Study Design

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

85 Years

Sex

MALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-03-01

Primary Completion

2026-12-31

Completion

2027-03-31

Countries

• China

Study Locations