Computer simulation of the probability of detecting low volume carcinoma of the prostate with six random systematic core biopsies

Daneshgari, Firouz; Taylor, G. D.; Miller, Gary J.; Crawford, E. David

doi:10.1016/s0090-4295(99)80051-x

Cited by 81 publications

(27 citation statements)

References 15 publications

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“…5 Daneshgari et al had previously demonstrated in their computer simulation that only 20.3% of their prostate models had a tumor distribution for which the systematic sextant biopsy technique had a 95% probability of detecting the tumor. 6 In addition they found that 26.8% of the prostates had a tumor distribution that was completely disjointed from the six recommended biopsy regions. Crawford et al constructed 3-D computer prostate models using autopsy prostate specimens of patients with clinically undetected prostate cancer.…”

Section: Introductionmentioning

confidence: 98%

Investigating the distribution of prostate cancer using three-dimensional computer simulation

Opell

Zeng

Bauer

et al. 2002

Prostate Cancer Prostatic Dis

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The objective of this work was to investigate the distribution of prostate cancer using three-dimensional (3-D) computer simulation. Two hundred and eightyone 3-D computer prostate models were constructed from radical prostatectomy specimens. An algorithm was developed which divided each model into 24 symmetrical regions, and it then detected the presence of tumor within an individual region. The distribution rate of prostate cancer was assessed within each region of all 281 prostate models, and the difference between the rates was statistically analyzed using Mantel-Haenszel methodology. There was a statistically significant higher distribution rate of cancer in the posterior half (57.2%) compared to the anterior half ( 40.5%; P ¼ 0.001). The base regions (36.8%) had a statistically significant lower distribution rate than either the mid regions (56.3%; P ¼ 0.001) or the apical regions (53.5%; P ¼ 0.001). The mid regions did have a statistically significant higher distribution rate compared to the apical regions (P ¼ 0.032). There was no statistically significant difference between the distribution rate on the left half (48.5%) compared to that on the right half (49.2%; P ¼ 0.494). The spatial distribution of prostate cancer can be analyzed using 3-D computer prostate models. The results illustrate that prostate cancer is least commonly located in the anterior half and base regions of the prostate. Through an analysis of the spatial distribution of prostate cancer, we believe that new optimal biopsy strategies and techniques can be developed.

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Section: Introductionmentioning

confidence: 98%

Investigating the distribution of prostate cancer using three-dimensional computer simulation

Opell

Zeng

Bauer

et al. 2002

Prostate Cancer Prostatic Dis

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“…Furthermore, a needle angle of 30°gave significantly better results than 45°or 60°. Sextant biopsies were superior to random biopsies (132).…”

Section: Trus Guided Systematic Sextant Biopsymentioning

confidence: 88%

Screening for Prostate Cancer - More Questions than Answers

Rietbergen¹,

Schröder²

1998

Acta Oncologica

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“…According to this technique, three biopsy cores are taken from each side (right and left) of the prostate, 1 cm apart along the parasagittal area. However, concerns have arisen that the sextant biopsy method undersamples the prostate [15] , and consequently may fail to detect a significant proportion of clinically important tumors [16] . Moreover, Svetec et al [17] proved that the standard sextant biopsy technique could 'miss' more than 45% of already confirmed cancers by performing sextant biopsies in glands obtained from radical prostatectomy specimens.…”

Section: Discussionmentioning

confidence: 99%

Impact of Additional Sampling in the TRUS-Guided Biopsy for the Diagnosis of Prostate Cancer

Stamatiou

Alevizos

Karanasiou³

et al. 2007

Urol Int

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Aim: To evaluate the diagnostic value of 10+ systematic sampling technique when performing transrectal ultrasound-guided (TRUS) prostate biopsy, compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: 286 patients with suspected prostate cancer were included in the study. Patients were eligible for the study if they had serum levels of prostate-specific antigen (PSA) >4 ng/ml or ratio PSA <0.25 and/or an abnormal digital rectal examination (DRE). The population sample was divided in three groups: (1) those with positive PSA, PSA ratio and DRE (70 patients); (2) those with positive PSA and PSA ratio but normal DRE (178 patients), and (3) those with positive PSA and PSA ratio, positive PSA velocity and a negative biopsy in the previous 6-month period (38 patients). In addition to the conventional sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone (10 core biopsy protocol). Additional cores (total of 12–14) were also randomly selected in case of larger prostates (>60 ml) or from suspicious foci revealed by transrectal ultrasound. All additional biopsy cores were submitted separately to the pathological department. Results: Cancer was detected in 55.7% (39/70) and 69% (48/70) of the patients (for sextant core and for the extended biopsy protocols, respectively) in the first study group, 11% (20/178) and 23% (41/178) of the patients (for the sextant and the extended biopsy protocols, respectively) in the second study group, and 42% (16/38) and 63% (24/38) of the patients (for the sextant and the extended biopsy protocols, respectively) in the third study group. The addition of the lateral peripheral zone (PZ) of the prostate to the sextant biopsy showed a 23, 105 and 50% increase in the number of cancers diagnosed in the first, second and third study groups, respectively. The improvement of cancer detection rate (sensitivity) was statistically significant for all groups evaluated. Conclusion: The 10+ systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer compared to the sextant biopsy technique alone, especially when performed in men with positive PSA, PSA ratio, and negative DRE.

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Computer simulation of the probability of detecting low volume carcinoma of the prostate with six random systematic core biopsies

Cited by 81 publications

References 15 publications

Investigating the distribution of prostate cancer using three-dimensional computer simulation

Investigating the distribution of prostate cancer using three-dimensional computer simulation

Screening for Prostate Cancer - More Questions than Answers

Impact of Additional Sampling in the TRUS-Guided Biopsy for the Diagnosis of Prostate Cancer

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