Introduction: The role of transperineal template biopsy for prostate cancer diagnosis is well established. Pre-biopsy multiparametric magnetic resonance imaging (MRI) is used in most centers for planning of prostate biopsies and staging. Cognitive and software fusion techniques are increasingly getting popular. Methods: We retrospectively reviewed patients who underwent transperineal template biopsies from January 2016 till December 2018. This included patients on active surveillance, previous negative transrectal ultrasonography biopsies with persistently raised prostate-specific antigen/abnormal prostate on digital rectal examination and de-novo template biopsies. Two specialist uro-radiologists reported all the scans and the biopsies were performed by one experienced urologist. The cognitive biopsies were performed for PIRADS 3-5 lesions on MRI. Total of 330 patients underwent transperineal template biopsies and cognitive target biopsies were carried out in 75 patients who were included in the study. We evaluated the results as positive/negative cognitive biopsies and also according to the PIRAD scoring. Only the patients with prostate cancer on template biopsy histology were included. Results: Fifty-seven (76%) of the cognitive biopsies were positive out of total 75.    PIRAD Score P ositive N egative              PIRAD 3 8 (53.33%) 7             PIRAD 4 36 (83.72%) 7             PIRAD 5 13 (76.47%) 4           Conclusions: Combined cognitive and systematic biopsies have excellent diagnostic rate especially for PIRAD 4-5 MRI areas.

The aging male : the official journal of the International Society for the Study of the Aging Male. 2019 Jul 18 [Epub ahead of print]

Zubair Bhat, Arshad Bhat, Wasim Mahmalji

a Department of Urology , Medway Maritime Hospital Hospital , Gillingham , Kent , United Kingdom., b Department of Urology , Hereford County Hospital , Hereford , United Kingdom.