磁共振成像 (MRI) 深刻改变了检测前列腺癌的前列腺活检策略。然而，经直肠 (TR) 和经会阴 (TP) MRI 靶向活检 (MRI-TB) 的检出率是否存在差异仍存在争议。为了比较这两种方法检测整体前列腺癌 (PCa) 和临床显着性前列腺癌 (csPCa) 的有效性，我们进行了回顾和荟萃分析。直到 2023 年 1 月，我们对 Cochrane、Embase、Ovid、和考研。总共识别出 1482 条参考文献，最终纳入 15 条记录。对于 TP 和 TR MRI-TB 发现的 PCa 和 csPCa，我们将相对敏感性 (RR) 与 95% 置信区间 (CI) 结合起来。建立了 TP 和 TR 途径之间的 RR。我们的研究总共包括 8826 名患者，结果显示 TP MRI-TB 检测到更多的 PCa（RR 1.25 [95% CI 1.12, 1.39]，p<0.0001）。在同时或分别接受 TP MRI-TB 和 TR MRI-TB 的患者中，在每名患者分析中，TP MRI-TB 的 csPCa 检出率更高（一组（RR 1.33 [95% CI 1.09, 1.63]） ，p = 0.005）；两个队列（RR 1.37 [95% CI 1.16，1.61]，p  = 0.0002））。然而，在每个病灶分析中，TP 途径和 TR 途径之间的 csPCa 检出率相当（RR 0.91 [95% CI 0.76, 1.08]，p  = 0.28）。此外，在前列腺前部区域，我们发现 TP MRI-TB 检测到更多的 csPCa（每个病灶（RR 1.52 [95% CI 1.04, 2.23]，p  = 0.03）；每个患者（RR 2.55 [95% CI 1.56]） , 4.16], p  = 0.0002))。根据这项综合研究，TP MRI-TB 在检测 PCa 和 csPCa 方面比 TR MRI-TB 更有效。检测位于前区的 csPCa 仍具有显着结果。尽管纳入的研究之间存在异质性，但仍需要谨慎对待结果。© 2023。作者，获得施普林格自然有限公司的独家许可。

Magnetic resonance imaging (MRI) has deeply altered the prostate biopsy strategy to detect prostate cancer. However, it is still debatable whether the detection rate differs between transrectal (TR) and transperineal (TP) MRI-targeted biopsy (MRI-TB). To compare the effectiveness of these two methods for detecting both overall prostate cancer (PCa) and clinically significant PCa (csPCa), We performed a review and meta-analysis.Until January 2023, we conducted a thorough search of Cochrane, Embase, Ovid, and PubMed. In total, 1482 references were identified, and 15 records were finally included. For PCa and csPCa discovered by TP and TR MRI-TB, we combined the relative sensitivity (RR) with 95% confidence intervals (CI). The RR between the TP and TR routes was established.Our study included 8826 patients in total and revealed that TP MRI-TB detected more PCa (RR 1.25 [95% CI 1.12, 1.39], p < 0.0001). In patients who underwent TP MRI-TB and TR MRI-TB at the same time or separately, TP MRI-TB had a greater detection rate of csPCa in per-patient analysis (one cohort (RR 1.33 [95% CI 1.09, 1.63], p = 0.005); two cohorts (RR 1.37 [95% CI 1.16, 1.61], p  = 0.0002)). However, the detection rate of csPCa between the TP route and the TR route was comparable in per-lesion analysis (RR 0.91 [95% CI 0.76, 1.08], p  = 0.28). Additionally, in the prostate's anterior region, we found that TP MRI-TB detected more csPCa (per-lesion (RR 1.52 [95% CI 1.04, 2.23], p  = 0.03); per-patient (RR 2.55 [95% CI 1.56, 4.16], p  = 0.0002)).According to this comprehensive study, TP MRI-TB is more effective than TR MRI-TB at detecting PCa and csPCa. Significant results persisted for detecting csPCa located in the anterior zone. The results need to be taken carefully notwithstanding the heterogeneity among the included studies.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.