Prostate cancer (PCA) is the most frequent cancer among men. In order to overcome the practical
limitations ofprostatespecific antigen(PSA)screening, research in recent years has focused on developing more
precise imaging techniques.Objectives:This study aimed todetermine the function of multiparametric magnetic
resonance imaging (mpMRI)as a prebiopsy imaging decreasing the number of biopsies taken and role of combination
of mpMRI finding withstandardtransrectal ultrasound (TRUS)guided biopsyfindingsto improve efficacy of
standard TRUS biopsy.Patients and methods:This prospective study trial was completed on 124 patients suspicious
for cancer prostate as elevated total PSA > 10 ng/ml or in grey zone and free/total ratio less than 0.18 or suspicious
digital rectal examination who attended to the Urology Department of Benha University Hospital. All patients
underwent mpMRI then TRUS guided systematic biopsy. Further to that, TRUS guided targeted biopsy by cognitive
biopsy technique from suspicious lesions in the same session for those who hadpositive mpMRI finding.Results:
Regarding the agreement and performance characteristics between combined systematic and targeted biopsyin
relation to systematic biopsyalone among patients suspected of having prostate cancer, showed moderate agreement
(k=0.499), with 73.2 % sensitivity, 77.3 % specificity, 80.4 % PPV, 69.4 % NPV and 75.0 % accuracy.Conclusions:
Combined TRUS guided and Targeted biopsy improvedcancer detection rate in patients with PIRADs 2, 3, 4.