Prostate cancer is the most commonly diagnosed malignancy in men and continues to be a leading cause of cancer-related mortality. Accurate and timely diagnosis is essential for distinguishing clinically significant tumors from indolent lesions and for informing treatment decisions. Multiparametric magnetic resonance imaging (mpMRI) has revolutionized prostate cancer detection by enabling precise lesion localization, risk stratification, and improved biopsy targeting. Fusion biopsy, which combines mpMRI findings with real-time transrectal ultrasonography (TRUS), has emerged as a highly effective method for sampling suspicious lesions. This review provides an integrated anatomical, epidemiological, technical, and clinical overview that highlights the evolving role of fusion biopsy in contemporary prostate cancer diagnostics. We also explore emerging strategies such as penumbra-targeted sampling, discuss ongoing clinical challenges, and examine the impact of biopsy underestimation and lack of standardization. Compared to conventional systematic biopsy, mpMRI-TRUS fusion biopsy improves the detection of clinically significant prostate cancer while reducing the overdiagnosis of low-risk tumors. To our knowledge, few recent reviews have comprehensively synthesized current clinical guidelines, emerging biopsy techniques, and future directions within a single narrative. mpMRI-TRUS-guided fusion biopsy represents a major advancement in the prostate cancer diagnostic pathway, promoting precision oncology by reducing overtreatment and facilitating individualized patient care. This review aims to assist clinicians in adopting biopsy innovations that enhance diagnostic accuracy and improve patient outcomes.
前列腺癌是男性最常见的恶性肿瘤，也是癌症相关死亡的主要原因之一。准确及时的诊断对于区分具有临床意义的肿瘤与惰性病变、指导治疗决策至关重要。多参数磁共振成像（mpMRI）通过实现精确的病灶定位、风险分层和优化的活检靶向，彻底改变了前列腺癌的检测方式。融合活检技术结合mpMRI结果与实时经直肠超声（TRUS），已成为对可疑病灶进行采样的高效方法。本综述从解剖学、流行病学、技术及临床角度进行整合性概述，重点探讨融合活检在现代前列腺癌诊断中不断发展的作用。我们同时探讨了新兴策略（如半影靶向采样），分析了当前面临的临床挑战，并审视了活检低估与缺乏标准化所带来的影响。与传统系统活检相比，mpMRI-TRUS融合活检提高了具有临床意义前列腺癌的检出率，同时减少了对低风险肿瘤的过度诊断。据我们所知，近期少有综述能将现行临床指南、新兴活检技术及未来发展方向系统整合于同一论述中。mpMRI-TRUS引导的融合活检代表了前列腺癌诊断路径的重大进步，通过减少过度治疗、促进个体化诊疗，推动了精准肿瘤学的发展。本综述旨在帮助临床医生采纳可提升诊断精度、改善患者预后的活检技术创新。
Advances and Challenges in Prostate Cancer Diagnosis: A Comprehensive Review
肿瘤(癌症)患者之家