The purpose of this exhibit is to outlinethe role of template biopsy mapping and multiparametric MRI in the diagnosis of prostate cancer. We describe the technique of transperineal template biopsy mapping and compare it to the conventional TRUS guided method. We also demonstrate the clinical utility of multiparametric MRI, based on the PI-RADS scoring system in localising and staging prostate cancer.

Prostate cancer is the second most common cause of cancer related death in men [1]. Accurate diagnosis and staging is of paramount importance as treatment strategies have the potential to cause significant harm includingerectile dysfunction and incontinence [2]. Detection of clinically significant disease is of particular interest which includes Gleason scores≥7, volumes≥0.5cc and extraprostatic extension [3].TRUS biopsies are traditionally considered as the gold standard for prostate cancer diagnosis. There are a number of drawbacks associated with this technique. They have a high false negative rate,...

MRI which uses PI-RADS is the preferred imaging modality for detection and staging [8]. Multiple sequences are used which improves cancer detection rates [9]. The sensitivity and specificity is approximately 0.74 and 0.88 respectively with a negative predictive value ranging from 0.65 to 0.94 [10]. PI-RADS which stands for Prostate Imaging and Reporting and Data System, is a standardised reporting scheme used to detect prostate cancer. It is measured on a scale of 1 to 5 with 1 indicating benign lesions and 5 indicating highly...

Transperineal biopsy isre-emerging as a diagnostic tool due to the more widespread use of MRI guided biopsy which often uses the transperineal route. It has a number of advantages over the traditional transrectal approach. When used in conjunction with multiparametric MRI, prostate mapping leads to improved rates of cancer detection, improved accuracy in cancer grading and leads to a reduced risk of diagnosing clinically insignificant disease.

1.Siegel, R., et al. (2014). "Cancer statistics, 2014." CA Cancer J Clin 64(1): 9-29. 2. Tran, M., et al. (2016). "Combination of multiparametric MRI and transperineal template-guided mapping biopsy of the prostate to identify candidates for hemi-ablative focal therapy." BJU Int 117(1): 48-54. 3. Ploussard, G., et al. (2011). "The contemporary concept of significant versus insignificant prostate cancer." Eur Urol 60(2): 291-303. 4.Serefoglu, E. C., et al. (2013). "How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer?" Can Urol Assoc J...