Diagnostic Value of Ten Systematic TRUS-Guided Prostate Biopsies

Ravery, V.; Billebaud, T; Toublanc, M.; Boccon-Gibod, L; Hermieu, Jean-François; Moulinier, F; Blanc, Emmanuel; Delmas, V.; Boccon-Gibod, L

doi:10.1159/000019866

Cited by 38 publications

(19 citation statements)

References 13 publications

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“…Five biopsies were taken from each side of the prostate, all in the same plane and at the same angle. The additional biopsies yielded only a 3% diagnostic improvement when compared with systematic sextant biopsies alone [4].…”

Section: Introductionmentioning

confidence: 87%

“…However, others have shown that taking more biopsies without altering the angle of the biopsy needle or changing the regions of the prostate sampled may not improve cancer detection rates. Ravery et al [4] took systematic biopsies in 162 patients with suspected prostate cancer (PSA >4 ng/mL, with or without an abnormal DRE). In addition to the standard sextant biopsy regimen, two further parasaggital biopsies were obtained bilaterally, one between the standard apical and mid-gland biopsy sites, the other between the mid-gland and basal biopsy sites.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Durkan¹,

Sheikh²,

Johnson³

et al. 2002

BJU Int

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Objective To investigate whether taking two transition zone (TZ) and four lateral peripheral zone (PZ) biopsies in addition to routine parasaggital sextant biopsies would improve detection rates in men with suspected prostate cancer. Patients and methods The study included 493 consecutive men (mean age 68.7 years, SD 8.2) with elevated serum prostate-speci®c antigen (PSA) levels and/or abnormal ®ndings on a digital rectal examination who underwent transrectal ultrasonography-guided prostate biopsy. In addition to sextant biopsies, six further biopsies were obtained, two from the TZ (mid-gland) and four from the lateral PZ (base and mid-gland).Pathological ®ndings for the additional biopsies were compared with those of the sextant regions. Results Prostatic adenocarcinoma was diagnosed in 164 of the 493 (33%) men biopsied. Men with cancer were older, had smaller prostates and higher median PSA levels than men with negative biopsies. Sextant biopsies were positive for cancer in 133 of 164 (81%) men. All three sets of biopsies were positive in 53 (32%) cases. In 50 (30%) men both the sextant and lateral PZ biopsies were positive, while in six (4%) men, both sextant and TZ biopsies were positive. Thirty-one (19%) tumours were not detected by sextant biopsies, 10 (6%) where the lateral PZ biopsies alone were positive, 17 (10%) where the TZ biopsies alone were positive and four (3%) where both the TZ and lateral PZ together were positive. There were no differences in median PSA concentration, total prostate volume or TZ volume between men with an isolated TZ cancer and men with cancer elsewhere in the prostate. However, 77% of men with TZ cancer had a PSA of >10 ng/mL, compared with 60% of men with cancer at other sites within the prostate (P=0.015). Conclusion An extended-core biopsy protocol signi®cantly improves the detection rate for prostate cancer when compared with the standard sextant biopsy protocol alone. Routine TZ biopsies should be considered for men with serum PSA levels of >10 ng/mL.

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Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Durkan¹,

Sheikh²,

Johnson³

et al. 2002

BJU Int

View full text Add to dashboard Cite

show abstract

“…A recent study examined the diagnostic value of performing 10 systematic biopsies in 162 consecutive patients with a serum PSA b 4 ng/ml with or without an abnormal DRE. 27 In addition to the standard sextant biopsy regimen, two further para-saggital biopsies were obtained bilaterally, one between the standard apical and mid-gland biopsy sites, the other between the mid-gland and basal biopsy sites. A total of ®ve biopsies were taken from each side of the prostate, all in the same plane and at the same angle.…”

Section: Systematic Sextant Vs Extended Core Biopsiesmentioning

confidence: 99%

“…The additional biopsies yielded a mere 3% diagnostic improvement when compared with systematic sextant biopsies alone leading the authors to conclude that without altering the angle of biopsy or the area of the prostate sampled, no signi®cant increase in positive biopsy rate will result. 27 Perhaps the most sensible approach to this issue is that proposed by Presti and coworkers, who performed lateral peripheral zone biopsies of the base (two) and mid-gland (two) in addition to routine sextant biopsies in 483 consecutive men referred for biopsy with an abnormal DRE and/or an elevated serum PSA. 28 Two-hundred and two cancers (42%) were detected, the majority (96%) by the combination of lateral peripheral zone and sextant biopsies.…”

Section: Systematic Sextant Vs Extended Core Biopsiesmentioning

confidence: 99%

Diagnostic dilemmas in detection of prostate cancer in patients undergoing transrectal ultrasound-guided needle biopsy of the prostate

2000

Prostate Cancer Prostatic Dis

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“…The trend is now toward an increase in the number of biopsies and sampling the peripheral zone. Additional morbidity resulting from extensive protocols remains controversial 3 .…”

Section: Introductionmentioning

confidence: 99%

Prostate Biopsies Guided by Three-Dimensional Real-Time (4-D) Transrectal Ultrasonography on a Phantom: Comparative Study versus Two-Dimensional Transrectal Ultrasound-Guided Biopsies

Long¹,

Daanen²,

Moreau–Gaudry³

et al. 2007

European Urology

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Objective: The objective of the study is to evaluate the accuracy in localisation and distribution of real-time 3-dimension (4D) ultrasound guided biopsies on a prostate phantom.Methods: A prostate phantom was created. A 3D real-time ultrasound system with a 5.9MHz volumic endorectal probe was used, making it possible to see several reconstructed orthogonal viewing planes in real-time. Fourteen operators performed biopsies. Twelve cores were sampled by every operator, first under 2D then 4D TRUS guidance (336 biopsies).The biopsy path was modelled using segmentation in a 3D ultrasonographic volume. Each biopsy path was visualised using the trail left by the needle in the phantom. Only one biopsy was performed per phantom. The 3D volumes of each sampled phantom were then manually registered, without segmentation, with a reference phantom. Special software was used to visualise the biopsy paths in the reference prostate and assess the sampled area. A comparative study was performed to determine the benefits of 4D as compared to 2D TRUS guidance, looking at the accuracy of the entry points and target of the needle. Distribution was assessed by measuring the volume sampled and a redundancy ratio of the sampled voxels.Results: A significantly increase in accuracy in hitting the target zone was identified using 4D ultrasonography as compared to 2D. There was no increase in the sampled volume or improvement in the biopsy distribution with 4D ultrasonography as compared to 2D. Conclusion:The 4D TRUS guidance appears to show, on a synthetic model, an improvement in location accuracy and in the ability to reproduce a protocol. The biopsy distribution does not seem improved.2

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Diagnostic Value of Ten Systematic TRUS-Guided Prostate Biopsies

Cited by 38 publications

References 13 publications

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Diagnostic dilemmas in detection of prostate cancer in patients undergoing transrectal ultrasound-guided needle biopsy of the prostate

Prostate Biopsies Guided by Three-Dimensional Real-Time (4-D) Transrectal Ultrasonography on a Phantom: Comparative Study versus Two-Dimensional Transrectal Ultrasound-Guided Biopsies

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