Diagnostic Value of Rapid On-Site Evaluation Combined With Prostate Biopsy in Prostate Cancer.

[OBJECTIVE] To investigate the application value of Rapid On-Site Evaluation (ROSE) in prostate biopsy.

[METHODS] All consecutive subjects who attended our clinic to underwent magnetic resonance imaging (MRI)-ultrasound fusion biopsy due to highly suspicious findings on MRI for prostate cancer (PCa) and met the inclusion criteria were enrolled into our prospective study between October 2020 and January 2025. ROSE was performed concurrently in the same operating room with MRI-ultrasound fusion biopsy. For each lesion with Prostate Imaging-Reporting and Data System (PI-RADS) 4-5, one to two additional needle passes were taken for ROSE, in addition to the standard biopsy. The results of ROSE during the biopsy were recorded. The sensitivity, specificity, positive predictive value, and negative predictive value of ROSE were assessed using paraffin-embedded histopathology of the biopsy specimens as the gold standard.

[RESULTS] A total of 313 lesions with PI-RADS 4-5 from 147 patients were ultimately included in this study. All biopsies were performed smoothly, with no severe complications occurring postoperatively. 192 lesions were pathologically diagnosed with PCa, yielding a positive detection rate of 61.3% (192/313). With paraffin-embedded histopathology of the biopsy specimens serving as the gold standard, the sensitivity of ROSE for detecting PCa was 71.9% (138/192), specificity was 100% (121/121), accuracy was 82.7% (259/313), positive predictive value was 100% (138/138), and negative predictive value was 69.1% (121/175).

[CONCLUSIONS] The application of ROSE technology in the diagnosis during prostate biopsy is accurate and reliable, with specificity and positive predictive value both reaching 100%.