A Prospective, Randomized Trial Comparing Office-based MR-guided Prostate Biopsy Approaches

This randomized trial will compare the safety and efficacy of TPM versus TRUS biopsies performed in the outpatient setting. Primary endpoints will be pain as well as detection of clinically significant disease (defined as Gleason Score \>=7 or cancer core length \>=6 mm). Secondary endpoints will be detection of any prostate cancer, hospital re-admissions within 30 days, aborted procedures due to discomfort, procedure time, adverse events including hematuria, urinary retention, hematospermia, hematochezia, and infection, and patient-reported outcomes as measured on validated instruments such as International Prostate Symptom Scores (IPSS) and International Index of Erectile Function (IIEF-5). In men who subsequently elect to undergo radical prostatectomy for definitive treatment of their prostate cancer, Gleason scores at final pathology will be correlated to the Gleason scores obtained at time of biopsy.

Sex

Male

Minimum age

18 Years

Inclusion Criteria:

* Men 18 years or older with suspicion for prostate cancer based upon an elevated PSA, abnormal digital rectal examination, abnormal MRI
* Men on active surveillance with indication for biopsy

Exclusion Criteria:

* Men with active urinary tract infection, metastatic prostate cancer, history of colorectal surgery limiting insertion of transrectal probe, evidence of acute or chronic prostatitis, or concern for perineal cellulitis or fistula
* Men unfit to undergo prostate biopsy under local anesthesia
* Men with prior definitive therapy for prostate cancer, such as radiation therapy or partial gland ablation
* Men with contraindication to prostate MRI (claustrophobia, pacemaker, chronic kidney disease)