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Objectives: To report clinical results of early experience of manually controlled targeted biopsy with real-time multiparametric magnetic resonance image (mpMRI)-transrec‐ tal ultrasound (TRUS) fusion images for the diagnosis of prostate cancer. Methods: One hundred sixty-eight patients who were suspected of prostate cancer from mpMRI scans were recruited prospectively. We performed targeted biopsies for each cancer-suspicious lesion and 12 systematic biopsies using the BioJet® system. Patho‐ logical findings of targeted and systematic biopsies were analyzed. Results: Median age of the 168 patients was 67 years (range: 52–89). Median preopera‐ tive prostate specific antigen (PSA) value was 6.9 ng/ml (range: 3.54–20). Median preoperative prostate volume was 37 ml (range: 22–68). The number of the cancerdetected cases was 99 (59%). The median biopsy time, included the MRI-TRUS fusion time and needle-punctured time without the anesthesia, was 8 minutes (range: 5–65). Cancer-detected rates of the systematic and targeted biopsy cores were 5.9 and 38%, respectively (p < 0.0001). In 25 patients who underwent radical prostatectomy, the geographic locations and pathological grades of clinically significant cancers and index lesions corresponded to the pathological results of the targeted biopsies. Conclusion: The cancer cores detected by targeted biopsies with manually controlled targeted biopsy with real-time mpMRI-TRUS fusion image had significantly higher grades and larger length compared with those detected by the systematic biopsies. The further study of the comparisons with pathological findings of whole-gland speci‐ mens will give a larger role to the present biopsy method.

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Transperineal Targeted Biopsy with Real-Time Fusion Image of Multiparametric Magnetic Resonance Image and Transrectal Ultrasound Image for the Diagnosis of Prostate Cancer