Diagnostic performance and safety of a three‐dimensional 14‐core systematic biopsy method

Abstract

ObjectiveTo investigate the diagnostic performance and safety of a three-dimensional 14-core biopsy (3D14PBx) method, which is a combination of the transrectal six-core and transperineal eight-core biopsy methods. Patients and MethodsBetween December 2005 and August 2010, 1103 men underwent 3D14PBx at our institutions and were analysed prospectively. Biopsy criteria included a PSA level of 2.5-20 ng/mL or abnormal digital rectal examination (DRE) findings, or both. The primary endpoint of the study was diagnostic performance and the secondary endpoint was safety. We applied recursive partitioning to the entire study cohort to delineate the unique contribution of each sampling site to overall and clinically significant cancer detection. ResultsProstate cancer was detected in 503 of the 1103 patients (45.6%). Age, family history of prostate cancer, DRE, PSA, percentage of free PSA and prostate volume were associated with the positive biopsy results significantly and independently. Of the 503 cancers detected, 39 (7.8%) were clinically locally advanced (≥cT3a), 348 (69%) had a biopsy Gleason score (GS) of ≥7, and 463 (92%) met the definition of biopsy-based significant cancer. Recursive partitioning analysis showed that each sampling site contributed uniquely to both the overall and the biopsy-based significant cancer detection rate of the 3D14PBx method. The overall cancer-positive rate of each sampling site ranged from 14.5% in the transrectal far lateral base to 22.8% in the transrectal far lateral apex. As of August 2010, 210 patients (42%) had undergone radical prostatectomy, of whom 55 (26%) were found to have pathologically non-organ-confined disease, 174 (83%) had prostatectomy GS ≥7 and 185 (88%) met the definition of prostatectomy-based significant cancer. ConclusionsThis is the first prospective analysis of the diagnostic performance of an extended biopsy method, which is a simplified version of the somewhat redundant super-extended three-dimensional 26-core biopsy. As expected, each sampling site uniquely contributed not only to overall cancer detection, but also to significant cancer detection. 3D14PBx is a feasible systematic biopsy method in men with PSA <20 ng/mL.

Magnetic resonance imaging/transrectal ultrasound fusion‐targeted prostate biopsy using three‐dimensional ultrasound‐based organ‐tracking technology: Initial experience in Japan

“…These detection rates might not be simply compared with each other, as the patient backgrounds including the distribution of MRI scores and PSA are different among the biopsy reports in Japan. However, the CDRs of both any cancer and CSCa by MRUS fusion biopsy technique TB might be greater than the conventional biopsy technique in those reported previous studies . In the present study, CDRs of CSCa per patient were 45.8% in SBx versus 70.2% in MRUS TB ( P < 0.0001).…”

“…Distribution of GS (6/7/8/9/10) was 46/101/35/14/2 in Likert scores 4 and 5 versus 2/4/2/1/0 in Likert score 3 (P < 0.001). MCCL was 8 mm (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) in Likert scores 4 and 5 versus 5 mm (2-15) in Likert score 3 (P < 0.05). The distribution of tumors detected, as well as GS differences in TB and SBx were evaluated.…”

“…Table shows the comparison of CDRs in the recent English reports in Japanese patients . The CDRs were available for all eight trials.…”

“…Table 5 shows the comparison of CDRs in the recent English reports in Japanese patients. [13][14][15][16][17][18][19] The CDRs were available for all eight trials. The CDRs of SBx were 47.9% and 45.6% for all prostate cancers, whereas the rates of CSCa were 32.5% and 42%, respectively.…”

Frequency of Propionibacterium acnes Infection in Prostate Glands with Negative Biopsy Results Is an Independent Risk Factor for Prostate Cancer in Patients with Increased Serum PSA Titers

“…All patients were suspected to have PCa based on an increased serum PSA titer (> 4 ng/ml), and had undergone prostate needle biopsy two or three times due to a negative first biopsy. Prostate needle biopsy was performed by the transrectal [8] or transperineal [9] method, or a combination of these methods [10,11]. Samples from the first and last needle biopsy were used for all patients enrolled in the study.…”