Clinical Application of Systematic Prostate Biopsy Combined with Contrast-Enhanced Ultrasound Guided Targeted Biopsy in Patients with PSA Gray Zone

To investigate the clinical value of combining systematic prostate biopsy with contrast-enhanced ultrasound (CEUS)-guided targeted biopsy in patients with serum prostate-specific antigen (PSA) levels in the gray zone. A total of 167 patients in the PSA gray zone treated at Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 2022 to October 2024 were retrospectively analyzed and divided into a systematic biopsy group and a combined biopsy group. Both groups underwent transperineal biopsy under transrectal ultrasound guidance. In the combined biopsy group, CEUS was used to identify suspicious lesions for targeted biopsy, followed by reduced-core systematic biopsy in non-targeted regions; both groups received 10-core biopsies. The combined targeted biopsy group showed significantly higher detection rates for prostate cancer (PCa) (57.32