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                <title xml:lang="en">Impact of Relative Volume Difference Between Magnetic Resonance Imaging and Three-dimensional Transrectal Ultrasound Segmentation on Clinically Significant Prostate Cancer Detection in Fusion Magnetic Resonance Imaging–targeted Biopsy</title>
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                <term xml:lang="en">diagnostic performance</term>
                <term xml:lang="en">MRI</term>
                <term xml:lang="en">Ultrasound</term>
                <term xml:lang="en">3D</term>
                <term xml:lang="en">image segmentation</term>
                <term xml:lang="en">prostate</term>
                <term xml:lang="en">image-guided biopsy</term>
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              <p>Background: The segmentation of 3D transrectal ultrasound (TRUS) images is known to be challenging and the clinician often lacks a reliable and easy-to-use indicator to assess its accuracy during the fusion MRI-targeted prostate biopsy procedure. Objective: To assess the effect of the relative volume difference between 3D-TRUS and MRI segmentation on the outcome of targeted biopsy.Design, Setting, and Participants: All adult males who underwent MRI-targeted prostate biopsy for clinically suspected prostate cancer between February 2012 and July 2021 were consecutively included. Intervention: All patients underwent fusion MRI-targeted prostate biopsy with a KoelisTM device.Outcome Measurements and Statistical Analysis: 3D-TRUS and MRI prostate volumes were calculated using 3D prostate models issued from the segmentations. The primary outcome was the relative Segmentation Volume Difference (SVD) between transrectal ultrasound and MRI divided by the MRI volume (SVD =MRI volume - TRUS volume / MRI volume) and its correlation to clinically significant prostate cancer (e.g., ISUP≥ 2) positiveness on targeted biopsy cores. Results: Overall, 1721 patients underwent targeted biopsy resulting in a total of 5593 targeted cores. The median relative SVD was significantly lower in patients diagnosed with clinically significant prostate cancer compared to those with ISUP 0-1: (6.7%[IQR-2.7,13.6] vs.8.0%[IQR3.3,16.4],p&amp;lt;0.01, respectively). Multivariate regression analysis showed that a relative SVD of more than 10% of the MRI volume was associated with a lower detection rate of clinically significant prostate cancer (OR=0.74[95CI:0.55-0.98];p=0.038).</p>
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</TEI>