Systematic 12- and 13-core transrectal ultrasound- or magnetic resonance imaging-guided biopsies significantly improve prostate cancer detection rate: A single-center 13-year experience.

Gong Cheng,Pengfei Shao,Bianjiang Liu,Changjun Yin,Chao Qin,Yuan Huang,Jie Li,Ruizhe Zhao,Lixin Hua

doi:10.3892/ol.2014.2353

Gong Cheng, Pengfei Shao + Show 7 more

Open Access

https://doi.org/10.3892/ol.2014.2353

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Abstract

The aim of the present study was to evaluate the value of systematic 12- and 13-core biopsies, guided by transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI), with regard to the prostate cancer detection rate (PCDR). Between July 1999 and June 2012, 2,707 patients were recruited to the Department of Urology, The First Affiliated Hospital of Nanjing Medical University (Nanjing, China). Prostate biopsies were performed via systematic 12- or 13-core biopsy and guided by either TRUS or MRI. The PCDR was established by retrospectively analyzing the distribution of positive cores, and it was assumed that all patients had undergone four biopsy schemes: Medial 6-core, lateral 6-core, 12-core and entire 13-core. In addition, the positive rate of the biopsies with the extra 13th core and the mean positive rate of systematic 12-core biopsies were compared. The PCDR of an entire 13-core biopsy was significantly higher than that of a lateral 6-core biopsy. The positive rate of the extra 13th core, which identified abnormal TRUS or MRI findings, was significantly higher when compared with that of the mean positive rate of the systematic 12-core biopsy. The results of the present study demonstrated that the entire 13-core biopsy was superior to the 6-core biopsy with regard to the PCDR. Therefore, the systematic 12-core biopsy with an extra 13th core is considered to be beneficial towards improving the PCDR.

Highlights

The sextant method for performing a prostate biopsy was introduced by Hodge et al [1] in 1989
Magnetic resonance imaging (MRI)‐guided and robotic‐assisted prostate biopsies have been attempted at various advanced medical centers [10,11]; transrectal ultrasound (TRUS)‐guided prostate biopsy remains the standard regimen for prostate cancer detection at the majority of medical centers
There was no statistical difference identified in the prostate cancer detection rate (PCDR) at prostate‐specific antigen (PSA) >30 ng/ml (79.1% vs. 73.4%, P= 0.111) or prostate volume (PV) ≤46 cm3 (46.8% vs. 44.3%, P=0.336)

Summary

Introduction

The sextant method for performing a prostate biopsy was introduced by Hodge et al [1] in 1989. The optimal number of biopsy cores and distribution, remains controversial

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Conclusion