Abstract
BackgroundWe evaluated the cancer detection rate of prostate cancer using transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume for patients requiring repeated prostate biopsies.MethodsIn total, 103 consecutive patients with repeated prostate biopsies were enrolled in this retrospective study. The number of biopsy cores was defined by prostate volume. In principle, one biopsy core covered 1 mL of prostate volume. We used a prostate brachytherapy template with a 5-mm grid and adopted a transperineal needle biopsy.ResultsThe median age, prostate-specific antigen level, and prostate volume were 69 (range, 37–83) years, 9.2 (range, 1.9–107) ng/mL, and 34.7 (range, 18–76.7) mL, respectively. The median number of biopsy cores was 37 (range, 18–75 cores). Fifty-three patients (51.5%) were diagnosed with prostate cancer. The Gleason score was 6, 7, and 8–10 in 24.5, 64.2 and 11.3% patients, respectively. Forty-two patients (79.2%) were diagnosed with clinically significant PCa. Acute urinary retention was detected in 2 patients (1.9%).ConclusionsTransperineal template-guided saturation biopsy with one core per milliliter of prostate volume helped achieve a high cancer detection rate and high significant cancer detection rate with acceptable biopsy-associated adverse events.
Highlights
We evaluated the cancer detection rate of prostate cancer using transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume for patients requiring repeated prostate biopsies
Prostate-specific antigen (PSA) testing has been widely used for prostate cancer (PCa) screening, and transrectal ultrasound (TRUS)-guided biopsies have been widely performed [1, 2]
Patient selection From January 2008 to July 2014, we offered transperineal templateguided saturation biopsy (TTSB) for patients considered to need prostate repeat biopsy when the following clinical factors were present: increased PSA levels; abnormal findings on digital rectal examination (DRE), TRUS, or MRI; and a previous biopsy showing HGPIN and/or atypical small acinar proliferation (ASAP)
Summary
We evaluated the cancer detection rate of prostate cancer using transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume for patients requiring repeated prostate biopsies. Prostate-specific antigen (PSA) testing has been widely used for prostate cancer (PCa) screening, and transrectal ultrasound (TRUS)-guided biopsies have been widely performed [1, 2]. Even with contemporary use of laterally directed extended TRUS-guided biopsies, the false-negative rate remains high [3]. Patients with negative diagnosis by TRUS-guided biopsy may need repeat biopsy if the following findings are present: increased PSA levels; abnormal findings on digital rectal examination (DRE), TRUS, and MRI; and previous biopsy showing high-grade. Saturation biopsy is performed via transrectal or transperineal routes, with high detection rates [8,9,10,11,12,13].
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