Comparative Performance of the CamPROBE Local Anaesthetic Transperineal Biopsy Device Versus an In-Line Device for Detection of Significant Prostate Cancer

<b>Background/Objective:</b> The CamPROBE device offers a simple, low-cost method to facilitate double-free-hand local anaesthetic transperineal prostate biopsies (LATPBx). Here we present data from prospective implementation of its use for first biopsy cancer detection. <b>Methods</b>: The outcomes of two centres who adopted the CamPROBE were compared to a retrospective series of biopsies using an in-line (single-free-hand) device. All biopsies were done by clinicians new to the device. Outcomes were the detection of any cancer and clinically significant prostate cancer (csPCa) defined as ≥Grade Group 2 and ≥Grade Group 3 (GG2/3) and composite ≥NICE Cambridge Prognostic Group 2 and 3 (CPG2/3), as well as sampling accuracy of MRI-defined lesions. <b>Results:</b> Device cohorts were well matched for pre-biopsy PSA, T stage, and MRI visibility in both centres. In centre 1 (100 CamPROBE vs. 97 in-line biopsies), there were no differences in detection of any cancer or csPCa: ≥GG2 60.0% vs. 56.7% (<i>p</i> = 0.64), ≥GG3 31% vs. 20.6% (<i>p</i> = 0.09), ≥CPG2 62.0% vs. 60.8% (<i>p</i> = 0.86), and ≥CPG3 (<i>p</i> = 0.55). There were also no differences between devices in target biopsy positivity: 67.4% vs. 63.5% (<i>p</i> = 0.59). Data from centre 2 (38 CamPROBE vs. 44 in-line) re-capitulated these findings. The MRI target detection rate of the CamPROBE (assessed in Centre 1) was not affected by prostate volume, lesion laterality, anatomical position, or lesion size. Limitations include modest sample sizes, lack of randomization, and patient-reported outcomes. <b>Conclusions</b>: These data demonstrate that the CamPROBE device is a highly effective method of performing prostate biopsies with excellent cancer detection rates and accuracy, supporting its wider dissemination and use.