1. The purposes of  ultrasound-guided prostate biopsy are to confirm the diagnosis, assess treatment efficacy, and evaluate disease progression.
   
2. Prostate biopsy can be performed via transrectal or perineal approaches.
   
3. Post-procedural care following ultrasound-guided prostate biopsy includes monitoring for hematuria, abstaining from sexual activity for two weeks, and avoiding heavy lifting for one month.
   
   

    According to statistics released by the Ministry of Health and Welfare in 2024, Among the ten leading causes of death in Taiwan, prostate cancer ranks fifth. With early diagnosis and effective treatments, the five-year survival rate can exceed 75%.
    The prostate is a glandular organ that resembles a chestnut in shape, weightss about 20 grams, and secretes prostate fluid, which is a component of semen. It is located below the bladder, surrounding part of the urethra, and is separated from the rectum by a fascial layer (Figure 1).

II.Why Undergo Ultrasound-Guided Prostate Biopsy

    Early-stage prostate cancer typically presents without symptoms. Currently, diagnosis involves a physician performing a digital rectal examination (DRE) and measuring blood levels of prostate-specific antigen (PSA). Additionally, depending on the clinical situation, the physician may consider newer diagnostic tests such as the Prostate Health Index (PHI) or magnetic resonance imaging (MRI) at the patient's expense. Based on the combined results of these examinations, a prostate biopsy under ultrasound guidance is performed to confirm the pathological diagnosis, Purpose：

1. To differentiate between various prostate pathologies.
   
2. To stage and diagnose prostate carcinoma.
   
3. To evaluate the therapeutic efficacy of radiation or hormone therapy in prostate cancer management.
4. To actively monitor the progression of untreated prostate carcinoma.
   
   

III.Examination Methods

    The physician conducts an ultrasound scan by inserting a lubricated transducer probe either into the perineal area or 2-4 centimeters into the rectum. When required, a prostate biopsy is performed under ultrasound guidance. For MRI-ultrasound fusion-guided biopsy, pre-acquired MRI images are fused with real-time ultrasound images to accurately plan and target the biopsy sites. The entire procedure typically takes approximately 30-60 minutes.

IV.Conclusion

    Patients undergo a digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) levels in the blood during outpatient visits. Combined with other assessments such as the Prostate Health Index (PHI) or magnetic resonance imaging (MRI), if abnormalities are detected, the physician will evaluate and schedule an ultrasound-guided prostate biopsy to confirm the pathological diagnosis. This assists the physician in clinical judgment and planning subsequent treatment.

VI.References

1. 王賢祥(2024，1月12日)。攝護腺癌診斷的利器-經直腸超音波攝護腺切片。https://www.vghtc.gov.tw/UnitPage/RowViewDetail?WebRowsID=57887c2b-b74b-447b-8fb2-c7d1e29134df&UnitID=b8390b70-75ec-4335-b22c-ce217ddcaad2&CompanyID=e8e0488e-54a0-44bf-b10c-d029c423f6e7&UnitDefaultTemplate=1
2. 廖博崎(2024年1月12日)。磁振造影融合影像機械手臂超音波引導經會陰攝護腺切片。https://www.vghtc.gov.tw/UnitPage/RowViewDetail?WebRowsID=cb0a2ca6-1b75-4c4b-90b3-dd8e434080ae&UnitID=b8390b70-75ec-4335-b22c-ce217ddcaad2&CompanyID=e8e0488e-54a0-44bf-b10c-d029c423f6e7&UnitDefaultTemplate=1
3. Chen, Y., Wang, Y., Wang, J., Rao, M., Li, C., Wang, Y., & Huang,    Y. (2025). Clinical study on mpMRI/TRUS software fusion-guided transperineal prostate biopsy. Journal of Men’s Health, 21(1), 81–86. https://doi.org/10.22514/jomh.2025.008
4. EAU guideline(2025).Prostate cancer. https://uroweb.org/guideline/prostate-cancer/
5. Wu, T. & Xing, Y. (2024). Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates. Open Medicine, 19(1), 20241039. https://doi.org/10.1515/med-2024-1039