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What is the ideal core number for ultrasound-guided prostate biopsy?

Chambó RC, Tsuji FH, de Oliveira Lima F, Yamamoto HA, Nóbrega de Jesus CM - Korean J Urol (2014)

Bottom Line: No significant differences in the cancer detection rate were found between the three biopsy protocols.PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798).Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy.

View Article: PubMed Central - PubMed

Affiliation: Graduate in Base of Surgery Program, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.

ABSTRACT

Purpose: We evaluated the utility of 10-, 12-, and 16-core prostate biopsies for detecting prostate cancer (PCa) and correlated the results with prostate-specific antigen (PSA) levels, prostate volumes, Gleason scores, and detection rates of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP).

Materials and methods: A prospective controlled study was conducted in 354 consecutive patients with various indications for prostate biopsy. Sixteen-core biopsy specimens were obtained from 351 patients. The first 10-core biopsy specimens were obtained bilaterally from the base, middle third, apex, medial, and latero-lateral regions. Afterward, six additional punctures were performed bilaterally in the areas more lateral to the base, middle third, and apex regions, yielding a total of 16-core biopsy specimens. The detection rate of carcinoma in the initial 10-core specimens was compared with that in the 12- and 16-core specimens.

Results: No significant differences in the cancer detection rate were found between the three biopsy protocols. PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798). The 10-, 12-, and 16-core protocols were compared with stratified PSA levels, stratified prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP; no significant differences were found.

Conclusions: Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy.

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Related in: MedlinePlus

Biopsy protocols: Protocol of Botucatu Medical School with 10 cores (A) - Protocol of Brazilian Society of Urology with 12 cores (B) - Overall total with 16 cores (C). 1, right base; 2, right middle third; 3, right apex; 4, latero-lateral right; 5, right medial; 6, left base; 7, left middle third; 8, left apex; 9, latero-lateral left; 10, left medial: 11, right base; 12, right middle third; 13, right apex; 14, left base; 15, left middle third; and 16, left apex.
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Figure 2: Biopsy protocols: Protocol of Botucatu Medical School with 10 cores (A) - Protocol of Brazilian Society of Urology with 12 cores (B) - Overall total with 16 cores (C). 1, right base; 2, right middle third; 3, right apex; 4, latero-lateral right; 5, right medial; 6, left base; 7, left middle third; 8, left apex; 9, latero-lateral left; 10, left medial: 11, right base; 12, right middle third; 13, right apex; 14, left base; 15, left middle third; and 16, left apex.

Mentions: A positive diagnosis of PCa was compared between the 10-core protocol (base, middle third, apex, medial [transitional zone] and latero-lateral, bilaterally) and the 12-core (base, middle third, apex, and more lateral regions of the base, middle third, and apex, bilaterally) and 16-core (overall total) protocols (Fig. 2). Tumor detection with the 10-, 12-, and 16-core protocols was correlated with PSA levels, prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP.


What is the ideal core number for ultrasound-guided prostate biopsy?

Chambó RC, Tsuji FH, de Oliveira Lima F, Yamamoto HA, Nóbrega de Jesus CM - Korean J Urol (2014)

Biopsy protocols: Protocol of Botucatu Medical School with 10 cores (A) - Protocol of Brazilian Society of Urology with 12 cores (B) - Overall total with 16 cores (C). 1, right base; 2, right middle third; 3, right apex; 4, latero-lateral right; 5, right medial; 6, left base; 7, left middle third; 8, left apex; 9, latero-lateral left; 10, left medial: 11, right base; 12, right middle third; 13, right apex; 14, left base; 15, left middle third; and 16, left apex.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231149&req=5

Figure 2: Biopsy protocols: Protocol of Botucatu Medical School with 10 cores (A) - Protocol of Brazilian Society of Urology with 12 cores (B) - Overall total with 16 cores (C). 1, right base; 2, right middle third; 3, right apex; 4, latero-lateral right; 5, right medial; 6, left base; 7, left middle third; 8, left apex; 9, latero-lateral left; 10, left medial: 11, right base; 12, right middle third; 13, right apex; 14, left base; 15, left middle third; and 16, left apex.
Mentions: A positive diagnosis of PCa was compared between the 10-core protocol (base, middle third, apex, medial [transitional zone] and latero-lateral, bilaterally) and the 12-core (base, middle third, apex, and more lateral regions of the base, middle third, and apex, bilaterally) and 16-core (overall total) protocols (Fig. 2). Tumor detection with the 10-, 12-, and 16-core protocols was correlated with PSA levels, prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP.

Bottom Line: No significant differences in the cancer detection rate were found between the three biopsy protocols.PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798).Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy.

View Article: PubMed Central - PubMed

Affiliation: Graduate in Base of Surgery Program, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.

ABSTRACT

Purpose: We evaluated the utility of 10-, 12-, and 16-core prostate biopsies for detecting prostate cancer (PCa) and correlated the results with prostate-specific antigen (PSA) levels, prostate volumes, Gleason scores, and detection rates of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP).

Materials and methods: A prospective controlled study was conducted in 354 consecutive patients with various indications for prostate biopsy. Sixteen-core biopsy specimens were obtained from 351 patients. The first 10-core biopsy specimens were obtained bilaterally from the base, middle third, apex, medial, and latero-lateral regions. Afterward, six additional punctures were performed bilaterally in the areas more lateral to the base, middle third, and apex regions, yielding a total of 16-core biopsy specimens. The detection rate of carcinoma in the initial 10-core specimens was compared with that in the 12- and 16-core specimens.

Results: No significant differences in the cancer detection rate were found between the three biopsy protocols. PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798). The 10-, 12-, and 16-core protocols were compared with stratified PSA levels, stratified prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP; no significant differences were found.

Conclusions: Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy.

Show MeSH
Related in: MedlinePlus