Abstract
Purpose
To investigate cancer detection rates and percentage of tumour per core between real-time sonoelastography (RTE) targeted biopsy and lateralised tenfold random biopsy of the prostate in the primary and re-biopsy setting.
Methods
Patients undergoing primary or re-biopsy of the prostate were included. Systematic RTE (EUB 7500, Hitachi Medical Systems, Tokio, Japan) was performed with the patient in the left lateral position. A maximum of four RTE targeted biopsies of the peripheral zone were taken following by a lateralised tenfold biopsy done by a second investigator blinded to the RTE findings. RTE targeted and random biopsy cylinders from corresponding areas were compared for percentage of tumour per core. Chi-square test and Wilcoxon signed rank test were used to compare differences between different groups.
Results
One hundred and thirty-nine patients were included (52 with primary biopsy, 87 with re-biopsy). Prostate cancer was found in 73 (52.5%) patients. Cancer detection rates per core were 23.2% versus 9.2% and 21.9% versus 12.7% for RTE targeted and random biopsies in the primary and re-biopsy setting, which was statistically significant (P < 0.05). The mean percentage of prostate cancer per core from corresponding areas was significantly higher in RTE targeted compared to random biopsy cores with 21.5% versus 16.4% (P < 0.05).
Conclusions
RTE targeted biopsy significantly increases cancer detection rates per core in comparison with random biopsy. The difference is more pronounced in the primary biopsy setting. RTE targeted biopsy cores are of improved diagnostic value due significantly higher percentages of cancer compared to random biopsy cores.
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References
Jemal A, Siegel R, Xu J, Ward E (2010) Cancer statistics, 2010. CA Cancer J Clin 60(5):277–300
Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E (1987) Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 317:909–916
Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED et al (2004) Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter. N Engl J Med 350:2239–2246
Bartsch G, Horninger W, Klocker H, Pelzer A, Bektic J, Oberaigner W, Schennach H, Schafer G, Frauscher F, Boniol M et al (2008) Tyrol prostate cancer demonstration project: early detection, treatment, outcome, incidence and mortality. BJU Int 101:809–816
Heidenreich A, Aus G, Bolla M, Joniau S, Matveev VB, Schmid HP, Zattoni F (2008) EAU guidelines on prostate cancer. Eur Urol 53:68–80
Hodge KK, McNeal JE, Terris MK, Stamey TA (1989) Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol 142:71–74 (discussion 74–75)
Sedelaar JP, Vijverberg PL, De Reijke TM, de la Rosette JJ, Kil PJ, Braeckman JG, Hendrikx AJ (2001) Transrectal ultrasound in the diagnosis of prostate cancer: state of the art and perspectives. Eur Urol 40:275–284
Pallwein L, Mitterberger M, Struve P, Horninger W, Aigner F, Bartsch G, Gradl J, Schurich M, Pedross F, Frauscher F (2007) Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection. Eur Radiol 17:2278–2285
Braeckman J, Autier P, Garbar C, Marichal MP, Soviany C, Nir R, Nir D, Michielsen D, Bleiberg H, Egevad L et al (2008) Computer-aided ultrasonography (HistoScanning): a novel technology for locating and characterizing prostate cancer. BJU Int 101:293–298
Loch T (2007) Computerized transrectal ultrasound (C-TRUS) of the prostate: detection of cancer in patients with multiple negative systematic random biopsies. World J Urol 25:375–380
Wink M, Frauscher F, Cosgrove D, Chapelon JY, Palwein L, Mitterberger M, Harvey C, Rouviere O, de la Rosette J, Wijkstra H (2008) Contrast-enhanced ultrasound and prostate cancer; a multicentre European research coordination project. Eur Urol 54:982–992
Krouskop TA, Younes PS, Srinivasan S, Wheeler T, Ophir J (2003) Differences in the compressive stress-strain response of infiltrating ductal carcinomas with and without lobular features: implications for mammography and elastography. Ultrason Imaging 25:162–170
Pelzer A, Bektic J, Berger AP, Pallwein L, Halpern EJ, Horninger W, Bartsch G, Frauscher F (2005) Prostate cancer detection in men with prostate specific antigen 4 to 10 ng/ml using a combined approach of contrast enhanced color Doppler targeted and systematic biopsy. J Urol 173:1926–1929
Frauscher F, Halpern EJ, Klauser A (2002) Accuracy of gray-scale and color Doppler US and serum markers as predictors of prostate carcinoma. Radiology 223:282–283 (author reply 283–284)
Salomon G, Kollerman J, Thederan I, Chun FK, Budaus L, Schlomm T, Isbarn H, Heinzer H, Huland H, Graefen M (2008) Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy. Eur Urol 54:1354–1362
Aigner F, Pallwein L, Junker D, Schafer G, Mikuz G, Pedross F, Mitterberger MJ, Jaschke W, Halpern EJ, Frauscher F (2010) Value of real-time elastography targeted biopsy for prostate cancer detection in men with prostate specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less. J Urol 184:913–917
Soloway MS, Soloway CT, Eldefrawy A, Acosta K, Kava B, Manoharan M (2010) Careful selection and close monitoring of low-risk prostate cancer patients on active surveillance minimizes the need for treatment. Eur Urol 58(6):831–835
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Ganzer, R., Brandtner, A., Wieland, W.F. et al. Prospective blinded comparison of real-time sonoelastography targeted versus randomised biopsy of the prostate in the primary and re-biopsy setting. World J Urol 30, 219–223 (2012). https://doi.org/10.1007/s00345-011-0679-y
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DOI: https://doi.org/10.1007/s00345-011-0679-y