Repeat biopsy techniques and outcomes in the detection of clinically significant prostate cancer

Introduction. Prostate biopsy remains the definitive standard for confirming malignancy in the prostate. However, a negative initial biopsy does not rule out the presence of prostate cancer (PCa) during subsequent follow-up. This review provides an overview of current repeat biopsy techniques and assesses their diagnostic accuracy for clinically significant PCa (csPCa). Objective. To study various methods of repeated biopsy and evaluate the results of diagnosis of csPCa. Materials & Methods. A review of PubMed, eLibrary electronic databases was conducted from 2000 to 2024 to identify all relevant studies. The electronic search was limited to Russian and English, and the keywords used were: repeat prostate biopsy, clinically significant prostate cancer, fusion biopsy. Results. Currently, the following techniques can be used to perform a repeat prostate biopsy: saturation biopsy, micro-ultrasound, histoscanning and fusion biopsy. Saturation biopsy is associated with an increase in the number of complications, histoscanning has not shown high efficiency, micro-ultrasound is not so common and is limited by the number of studies. The advantage of diagnosing csPCa in patients with a previous negative histological conclusion is currently behind fusion biopsy. One of the advantages is the ability to choose one of three execution techniques: fusion, cognitive and in bore. Conclusions. Fusion technique shows the best results of the effectiveness of the diagnosis of csPCa with repeated biopsy. According to the literature, various methods of performing fusion biopsies are comparable to each other.