Incremental detection rate of prostate cancer by real-time elastography targeted biopsies in combination with a conventional 10-core biopsy in 1024 consecutive patients.

Abstract:

OBJECTIVE:To quantify the incremental detection rate (DR) of a targeted biopsy in addition to a randomized 10-core biopsy. PATIENTS AND METHODS:This retrospective study analysed 1024 patients who consecutively underwent a four-core real-time elastography (RTE) targeted biopsies in addition to a randomized 10-core transrectal ultrasonography (TRUS)-guided biopsy in a primary or rebiopsy setting. The overall DR, the DR of a 10-core randomized, RTE targeted biopsy and the incremental DR were calculated. RESULTS:Overall, randomized and RTE targeted biopsy DRs (for the combination, the 10-core and the four-core RTE biopsy scheme) were 46.2% (n = 473), 39.1% (n = 400) and 29.0% (n = 297), respectively. Four-core RTE targeted biopsies detected an additional 73 patients not detected by the 10-core randomized biopsies (increase in the overall DR of 7.1%). This represented a relative increase in DR of 18.3%. The incremental DR was better in rebiopsy patients (24.8%) than in patients having their first biopsy (14.7%). Within all patients diagnosed by RTE targeted biopsy only, 34 patients harboured significant Gleason 4 or 5 prostate cancer (PCa), diagnosed by four-core RTE biopsy only. Moreover, PCa with a Gleason grade of 4 or 5 was detected by four-core RTE biopsies in 30 patients, who showed low-grade PCa ≤ Gleason 3 only in the systematic 10-core biopsy. CONCLUSIONS:Real-time elastography targeted biopsy seems to be an appropriate method for increasing the DR of PCa. Nevertheless, RTE targeted biopsies missed a high proportion of patients with PCa and should therefore be considered as an addition to randomized biopsies.

journal_name

BJU Int

journal_title

BJU international

authors

Salomon G,Drews N,Autier P,Beckmann A,Heinzer H,Hansen J,Michl U,Schlomm T,Haese A,Steuber T,Graefen M,Becker A

doi

10.1111/bju.12517

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

548-53

issue

4

eissn

1464-4096

issn

1464-410X

journal_volume

113

pub_type

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