Lateral biopsies added to the traditional sextant prostate biopsy pattern increases the detection rate of prostate cancer

Jochen, Bauer; Zeng, Jianchao; Zhang, W; McLeod, D. G.; Ia, Sesterhenn; Connelly, RR; Marie, Suely Kazue Nagahashi; Jw, Mason

doi:10.1038/sj.pcan.4500397

Cited by 23 publications

(9 citation statements)

References 24 publications

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“…In prior studies, investigators recommended an interval of 3 weeks between biopsy and MRI,2 and, more recently, investigators suggested that a post-biopsy interval of 8 weeks before MRI might be more beneficial 11. In addition, there has been a recent trend toward increased prostate sampling during transrectal biopsy; currently, more than six core biopsies are performed routinely 22. In our study, with a mean number of biopsy cores of 10.3, 91.4% of the biopsies had more than the typical six cores.…”

Section: Discussionmentioning

confidence: 99%

The optimal timing of post-prostate biopsy magnetic resonance imaging to guide nerve-sparing surgery

Song

Moon

et al. 2014

Asian J Androl

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The goal of our study was to evaluate the impact of the interval between prostate biopsy and magnetic resonance imaging (MRI) on the accuracy of simple tumor localization, which is essential information that enables nerve-sparing surgery. We also sought to determine the optimal timing of a post-biopsy MRI. A total of 184 patients who had undergone MRI before radical prostatectomy at an institution without a predetermined schedule for MRI after a prostate biopsy were enrolled. The mean interval from the biopsy to the MRI was 30.8 ± 18.6 days. The accuracy of the MRI for simplified tumor location (right, left, bilateral and none) was 44.6%. In the group with discordant pathologic and MRI findings, the most common reason recorded was ‘MRI predicted a unilateral lesion, but pathology revealed bilateral lesions’ (58.3%), followed by ‘MRI predicted no lesion, but pathology revealed the presence of a lesion’ (32.0%). Multivariable analysis showed that the discordant group had a shorter interval (25.0 ± 14.3 vs 38.1 ± 20.6 days, P < 0.01) preceding the MRI and a higher rate of hemorrhage as observed by MRI (80.4% vs 54.8%, P < 0.01) in comparison with the accordant group. In receiver operating characteristics analysis, the area under the curve of the MRI interval in accurate prediction of the tumor location was 0.707 (P < 0.001). At the MRI interval's cutoff of 28.5 days, the sensitivity was 73.2% and the specificity was 63.7%. When the MRI was performed within 28 days, the accumulated accuracy was only 26.1% (23/88); however, when it was performed after 28 days, the reversely accumulated accuracy was 61.5% (59/96). These data support a waiting period of at least 4 weeks after a biopsy before performing an MRI for the purposes of surgical refinement.

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Section: Discussionmentioning

confidence: 99%

The optimal timing of post-prostate biopsy magnetic resonance imaging to guide nerve-sparing surgery

Song

Moon

et al. 2014

Asian J Androl

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“…Transrectal ultrasound (TRUS) prostate biopsies were performed with the 10-core biopsy protocol described by Bauer et al [9], under antibiotic coverage. Prostate volume was determined by TRUS immediately before biopsy and was calculated using the prelate ellipsoid formula [10].…”

Section: Methodsmentioning

confidence: 99%

The Value of Digital Rectal Examination in Men With Lower Urinary Tract Symptoms and Prostate-Specific Antigen < 3 ng/mL

Nomikos¹,

Neill²,

Mariappan³

et al. 2010

UIJ

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“…The pattern advocated by Bauer et al [18] was a 10-core biopsy incorporating sextant plus bilateral laterally directed mid and apex cores. These same authors tested this pattern in a prospective study using their 10-core protocol to diagnose 35 consecutive prostate cancers, and found the laterally directed cores had the highest cancer detection rates [18]. The value of laterally directed biopsies has been confirmed by multiple investigators (Table 2).…”

Section: The Evolution From Sextant To Extended Core Biopsiesmentioning

confidence: 99%

Diagnostic accuracy of prostate needle biopsy

Donahue

Moul

2002

Curr Urol Rep

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The introduction of prostate-specific antigen screening has resulted in stage migration and an increased incidence of localized prostate cancer. In this era of increasing nonpalpable disease, it has become necessary to systematically sample the entire prostate gland. Transrectal ultrasound-guided prostate biopsy procedures have evolved greatly over the past decade from the original sextant biopsy. Technological advances, better understanding of zonal anatomy of the prostate, whole mount sectioning of radical prostatectomy specimens, and computer modeling of localized prostate cancers have all led to extended biopsy core protocols directed at the lateral zones of the gland. These have increased the diagnostic accuracy of needle biopsy and have become a standard regimen. However, it remains controversial how to proceed with repeat biopsy in the face of an initial benign diagnosis, and optimal biopsy strategy remains undefined. It is hoped that quantitative analysis of prostate biopsy histology may eventually provide some prognostic information to guide the patient and urologist in preoperative planning.

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Lateral biopsies added to the traditional sextant prostate biopsy pattern increases the detection rate of prostate cancer

Cited by 23 publications

References 24 publications

The optimal timing of post-prostate biopsy magnetic resonance imaging to guide nerve-sparing surgery

The optimal timing of post-prostate biopsy magnetic resonance imaging to guide nerve-sparing surgery

The Value of Digital Rectal Examination in Men With Lower Urinary Tract Symptoms and Prostate-Specific Antigen < 3 ng/mL

Diagnostic accuracy of prostate needle biopsy

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