%0 Journal Article
%T Cognitive fusion-targeted biopsy versus transrectal ultrasonography-guided systematic biopsy: comparison and analysis of the risk of Gleason score upgrading.
%A Zheng T
%A Bi K
%A Tang Y
%A Zeng Y
%A Wang J
%A Yan L
%J Int Urol Nephrol
%V 56
%N 3
%D 2024 Mar 24
%M 37875704
%F 2.266
%R 10.1007/s11255-023-03848-y
%X <B>OBJECTIVE: </B>The aim of this study is to assess the precision of the Gleason score (GS) obtained through cognitive fusion-targeted biopsy (COG-TB) in comparison to transrectal ultrasonography-guided systematic biopsy (TRUS-SB), and to identify factors that can predict Gleason score upgrading (GSU) in a cohort of Chinese patients.<BR><B>METHODS: </B>A final enrollment of 245 patients was recorded. Between 2020 and 2022, 132 patients underwent TRUS-SB, and 113 patients underwent COG-TB. The Chi-square test was performed to analyze the variation in downgrading, concordance, and upgrading between TRUS-SB and COG-TB. Multivariable analyses were performed to seek factors predicting Gleason score upgrading. Finally, a model which utilizes multivariable logistic regression was developed to predict the likelihood of GSU.<BR><B>RESULTS: </B>The concordance for TRUS-SB and COG-TB were 42.4% and 65.5%, respectively. TRUS-SB and COG-TB exhibited notable disparities in downgrading, concordance, and upgrading. Age, prostate volume, body mass index (BMI), and the biopsy modality were significant predictive factors.<BR><B>CONCLUSIONS: </B>COG-TB can significantly increase concordance with final histopathology. Age, prostate volume, BMI, and the biopsy modality were predictive factors of GSU.