The Development of the Modern Prostate Biopsy

Yeo, Lehana; Patel, Dharmesh; Bach, Christian; Papatsoris, Athanasios; Buchholz, Noor; Junaid, Islam; Masood, Junaid

doi:10.5772/28475

Cited by 11 publications

(19 citation statements)

References 59 publications

(50 reference statements)

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“…While the essence of this original system is still largely used today, the clinical practice and presentation of prostate cancer has changed dramatically over the past 50 years. In the late 1960s, there was no PSA screening, DRE screening was not routinely performed, and biopsy techniques were more limited . Consequently, men presented with more advanced disease .…”

Section: Discussionmentioning

confidence: 99%

Independent surgical validation of the new prostate cancer grade‐grouping system

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Independent surgical validation of the new prostate cancer grade‐grouping system

et al. 2016

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“…TRUS‐guided biopsies under local anaesthetic (LA) are associated with a risk of significant sepsis and understaging of disease, particularly in the anterior prostate . Conventional transperineal (TP) biopsies provide a more direct access to the prostate, but require complex equipment and a general anaesthetic (GA), making it impractical as an outpatient procedure.…”

Section: Introductionmentioning

confidence: 99%

Initial outcomes of local anaesthetic freehand transperineal prostate biopsies in the outpatient setting

et al. 2019

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Objectives To evaluate the histopathological outcomes, morbidity and tolerability of freehand transperineal (TP) prostate biopsies using the PrecisionPoint™ access system (Perineologic, Cumberland, MD, USA) under local anaesthetic (LA) in the day surgery and outpatient environments, as systematic and targeted biopsies can be taken with the potential for reduced morbidity, particularly sepsis. Patients and Methods In all, 176 patients underwent freehand TP prostate biopsies from May 2016 to November 2017. The procedure was carried out either under LA alone or with the addition of sedation. Magnetic resonance imaging (MRI) scans were reported using the Prostate Imaging‐Reporting and Data System (PI‐RADS), version 2. Tolerability was assessed using a visual analogue scale pain score for each procedural stage. Histopathological outcomes and complications were recorded. Results The mean (range) age was 65 (36–83) years, median (range) prostate‐specific antigen level was 7.9 (0.7–1374) ng/mL, and the mean (range) prostate volume 45 (15–157) mL. Biopsies were taken under LA alone (160 patients, 90%) or under LA with sedation (16, 9%). The main indication for biopsy was primary diagnosis (88.6%). In all, 91 (52%) patients underwent systematic TP biopsies (mean 24.2 cores). Cognitive MRI‐targeted biopsies alone were performed in 45 patients (26%; mean 6.8 cores), and 40 (23%) had both systematic and target biopsies (mean 27.9 cores). Of the 75 patients who had primary systematic biopsies alone, 46 (61%) were positive, and 28/46 (60.9%) were diagnosed with clinically significant disease (Gleason ≥3+4). VAS pain scores were greatest during LA administration. There were five complications (2.8%, Clavien–Dindo Grade I/II). No patients developed urosepsis. Conclusions Freehand TP biopsies using the PrecisionPoint access system is a safe, tolerable and effective method for systematic and targeted biopsies under LA in the outpatient setting. It has replaced transrectal biopsies in our centre and has potential to transform practice.

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“…Further refinement and evolution of the systematic sextant technique has continued in efforts to improve biopsy yield, with schemes that increase the number of systematic cores ranging from 10 to 18 per prostate, and some have even adopted ‘saturation biopsies’ (≥20 systematic cores per biopsy session) technique ; however, there continues to be much debate over the idealized schema for TRUS biopsy as PCa detection rates are low and range anywhere from 33 to 44%, and many of these tumours are not clinically significant . Recently, concern over the increasing risk of antibiotic‐resistant infection has prompted a re‐evaluation of patient preparation, as well as the number and frequency of prostate biopsies .…”

Section: Introductionmentioning

confidence: 99%

Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies

et al. 2014

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• Prostate MRI is currently the best diagnostic imaging method for detecting prostate cancer • Magnetic Resonance Imaging-Ultrasound (MRI/US) fusion allows the sensitivity and specificity of MRI to be combined with real time capabilities of transrectal ultrasound (TRUS). • Multiple approaches and techniques exist for MRI/US fusion and include (1) direct “in bore” MR biopsies, (2) cognitive fusion, and (3) MRI/US fusion via software-based image co-registration platforms.

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The Development of the Modern Prostate Biopsy

Cited by 11 publications

References 59 publications

Independent surgical validation of the new prostate cancer grade‐grouping system

Independent surgical validation of the new prostate cancer grade‐grouping system

Initial outcomes of local anaesthetic freehand transperineal prostate biopsies in the outpatient setting

Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies

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