Perilesional cores catch csPCa missed by targeting; systematic cores mainly add low-grade disease

Prospective · Urology · 2026-10-10. Number 3 in the UrologyWatch Top 5 for October 10, 2026.

In 566 robotic transperineal MRI/US fusion biopsies, perilesional cores (within 10mm of MRI lesion) found clinically significant cancer missed by targeted biopsy alone in 6.1% of cases, while systematic cores added little clinically significant cancer but increased detection of low-grade (GG1) disease by 24%.

Why it matters: Supports a targeted plus perilesional sampling strategy over routine systematic biopsy to reduce overdetection of indolent cancer while preserving significant cancer detection.

Source: Urology · PubMed 42854856 · DOI 10.1016/j.urology.2026.09.065

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