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Transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume: 103 cases requiring repeat prostate biopsy

View Article: PubMed Central - PubMed

ABSTRACT

Background: We evaluated the cancer detection rate of prostate cancer using transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume for patients requiring repeated prostate biopsies.

Methods: In total, 103 consecutive patients with repeated prostate biopsies were enrolled in this retrospective study. The number of biopsy cores was defined by prostate volume. In principle, one biopsy core covered 1 mL of prostate volume. We used a prostate brachytherapy template with a 5-mm grid and adopted a transperineal needle biopsy.

Results: The median age, prostate-specific antigen level, and prostate volume were 69 (range, 37–83) years, 9.2 (range, 1.9–107) ng/mL, and 34.7 (range, 18–76.7) mL, respectively. The median number of biopsy cores was 37 (range, 18–75 cores). Fifty-three patients (51.5%) were diagnosed with prostate cancer. The Gleason score was 6, 7, and 8–10 in 24.5, 64.2 and 11.3% patients, respectively. Forty-two patients (79.2%) were diagnosed with clinically significant PCa. Acute urinary retention was detected in 2 patients (1.9%).

Conclusions: Transperineal template-guided saturation biopsy with one core per milliliter of prostate volume helped achieve a high cancer detection rate and high significant cancer detection rate with acceptable biopsy-associated adverse events.

No MeSH data available.


Ultrasound image of the prostate showing the sites for sampling (black dots). Triangle shows urethra. Circle shows sites where sampling was avoided
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Fig1: Ultrasound image of the prostate showing the sites for sampling (black dots). Triangle shows urethra. Circle shows sites where sampling was avoided

Mentions: All procedures were performed in the operating room. TTSB was performed in the dorsal lithotomy position under either general or spinal anesthesia; a 14-French urethral catheter was inserted before the procedure. Every patient received premedication with a single dose of 1 g cefazolin by intravenous infusion for preventing infection caused by TTSB. DRE was performed, and a transrectal probe (Toshiba Medical, Tochigi, Japan) attached to a brachytherapy stepping unit (AccuSeed, Bedfordshire, UK) was then inserted into the rectum. The low-echoic area was estimated and prostate volume was calculated using the following formula: length × width × height × 0.5236 [22]. The number of biopsy cores was estimated using the widest transverse section (Fig. 1). The interval between biopsy cores in a row was uniformly 5 mm in rows from right to left in the longitudinal view, except for the area nearest to and around the urethra. At a point where sufficient sample was not taken from the apex of the bladder, an additional core was considered to take the sample from a point near the bladder. The number of additional cores taken was determined by the calculated prostate volume, and the number of biopsy cores was determined based on prostate volume. To achieve a “saturation biopsy,” one biopsy core per milliliter of prostate volume was required. The biopsy procedure was performed using an 18-gauge, 25-cm-long biopsy gun (Bard, Covington, GA, USA).Fig. 1


Transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume: 103 cases requiring repeat prostate biopsy
Ultrasound image of the prostate showing the sites for sampling (black dots). Triangle shows urethra. Circle shows sites where sampling was avoided
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5382378&req=5

Fig1: Ultrasound image of the prostate showing the sites for sampling (black dots). Triangle shows urethra. Circle shows sites where sampling was avoided
Mentions: All procedures were performed in the operating room. TTSB was performed in the dorsal lithotomy position under either general or spinal anesthesia; a 14-French urethral catheter was inserted before the procedure. Every patient received premedication with a single dose of 1 g cefazolin by intravenous infusion for preventing infection caused by TTSB. DRE was performed, and a transrectal probe (Toshiba Medical, Tochigi, Japan) attached to a brachytherapy stepping unit (AccuSeed, Bedfordshire, UK) was then inserted into the rectum. The low-echoic area was estimated and prostate volume was calculated using the following formula: length × width × height × 0.5236 [22]. The number of biopsy cores was estimated using the widest transverse section (Fig. 1). The interval between biopsy cores in a row was uniformly 5 mm in rows from right to left in the longitudinal view, except for the area nearest to and around the urethra. At a point where sufficient sample was not taken from the apex of the bladder, an additional core was considered to take the sample from a point near the bladder. The number of additional cores taken was determined by the calculated prostate volume, and the number of biopsy cores was determined based on prostate volume. To achieve a “saturation biopsy,” one biopsy core per milliliter of prostate volume was required. The biopsy procedure was performed using an 18-gauge, 25-cm-long biopsy gun (Bard, Covington, GA, USA).Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: We evaluated the cancer detection rate of prostate cancer using transperineal template-guided saturation biopsy aimed at sampling one core for each milliliter of prostate volume for patients requiring repeated prostate biopsies.

Methods: In total, 103 consecutive patients with repeated prostate biopsies were enrolled in this retrospective study. The number of biopsy cores was defined by prostate volume. In principle, one biopsy core covered 1 mL of prostate volume. We used a prostate brachytherapy template with a 5-mm grid and adopted a transperineal needle biopsy.

Results: The median age, prostate-specific antigen level, and prostate volume were 69 (range, 37–83) years, 9.2 (range, 1.9–107) ng/mL, and 34.7 (range, 18–76.7) mL, respectively. The median number of biopsy cores was 37 (range, 18–75 cores). Fifty-three patients (51.5%) were diagnosed with prostate cancer. The Gleason score was 6, 7, and 8–10 in 24.5, 64.2 and 11.3% patients, respectively. Forty-two patients (79.2%) were diagnosed with clinically significant PCa. Acute urinary retention was detected in 2 patients (1.9%).

Conclusions: Transperineal template-guided saturation biopsy with one core per milliliter of prostate volume helped achieve a high cancer detection rate and high significant cancer detection rate with acceptable biopsy-associated adverse events.

No MeSH data available.