LAUSR

SBx during MRI-TBx. METHODS: Patients previously submitted to negative-SBx (cohort A) and those enrolled in an AS program (cohort B) who showed at least one suspicious area with a PIRADSv2 score 3 3 were prospectively and randomly assigned to only TBx strategy vs TBx plus SBx strategy. SBx locations could not encompass the TBx sites, so that the results of each type of biopsy was independent and did not overlap. RESULTS: A total of 312 patients were included in the two cohorts (cohort A: 213 cases; cohort B: 99 cases). No significant differences were found in terms of overall PCa-DR (77,6% vs 69,6% respectively; p[0,36) and csPCa-DR (48,2% vs 60,9% respectively; p[0,12). The MRI-TBx alone cohort showed higher csPCa/PCa ratio (87,5% vs 62,2%; p[0,03). The MRI-TBx plus SBx group subanalysis showed significantly higher csPCa-DR obtained at the MRITBx cores when compared to the SBx cores (43,7% vs 24,1%, respectively; p[0.01). Independently to age, PSA and PI-RADS score, either in re-biopsy (OR 0.43, 0.21 e 0.97) or AS (OR 0.46, 0.32 e 0.89) setting, SBx cores were negatively associated with the csPCa-DR when combined to TBx cores. CONCLUSIONS: MRI-TBx should be considered the elective method to perform prostate biopsy in patients with previous negative SBx and those considered for an AS program. Adding SBx samples to MRI-TBx didn't improvedetection rate of csPCa.