Indications, strategies, and development on prostate targeted biopsy: Report of the Panjiayuan Consensus Conference 2022

Abstract Prostate biopsy is the gold standard for diagnosing prostate cancer (PCa). Prostate targeted biopsy (TB) having a higher rate of detecting clinically significant PCa (csPCa) than traditional systematic biopsy (SB) is supported by high‐quality evidence. However, the TB indications and strategies are controversial. The National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, invited a panel of recognized urology experts in PCa to address these topics at the Panjiayuan Consensus Conference 2022. The conference results on prostate TB are presented herein. The National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences identified 10 key areas of prostate biopsy: (1) selection of imaging examination; (2) indications of TB; (3) transperineal and transrectal prostate biopsy; (4) TB pathways; (5) TB and SB; (6) three techniques of TB; (7) the number of TB cores needed for one lesion; (8) core number for SB; (9) free‐hand TB; (10) future development of TB/prostate diagnosis. Thus, a panel of 25 recognized urologists and 2 radiologists from China were invited to attend this conference. The panel voted anonymously on 14 predetermined questions. Voting was based on the panelists' clinical practice and opinion, rather than high‐level evidence. The voting outcomes were supported by the panel unequally, and details of the voting results were reported. The voting results can help clinicians to decide on biopsy timing and proper strategies, for which guidelines are sparse. We also focused on the future development of TB and SB, such as the combined pathway of TB and SB, techniques of TB, biopsy cores, free‐hand TB, and prostate‐specific membrane antigen positron emission tomography/computed tomography.