F. Cornud, A. Lefèvre, Clinique de l'Alma, Paris, France, May 2019

Ploussard et al (1) answered positively in a recent review with the argument that systematic biopsies (SB), in addition to targeted biopsies (TB), improved the detection rate of significant cancers (defined by the presence of Gleason 4 grade) by about 10%.

The assumed reasons to explain this 10% gain are 1-the far lateral location of some cancers missed by targeted biopsies, 2-the prognostic value of systematic biopsies 3-the pitfalls of prostate MRI reporting. 4-the pitfalls of image fusion systems 5-the safety of systematic biopsies.