Extended and saturation needle biopsy for the diagnosis of prostate cancer

Chrouser, Kristin; Lieber, Michael M.

doi:10.1007/s11934-004-0041-7

Cited by 25 publications

(11 citation statements)

References 51 publications

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“…SPBx has been proven to lead to a more accurate assessment of the extent and grade of disease than traditional PBx in patient candidates for an active surveillance protocol [47,50,51,52,53]. Nevertheless, biopsy sampling error is a significant limitation of surveillance.…”

Section: Resultsmentioning

confidence: 99%

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Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

et al. 2012

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Introduction: Saturation prostate biopsy (SPBx) has been initially introduced to improve prostate cancer (PCa) detection rate (DR) in the repeat setting. Nevertheless, the optimal number and the most appropriate location of the cores, together with the timing to perform a second PBx and the eventual modification of the PBx protocols according to the different clinical situations, are matters of debate. The aim of this review is to perform a critical analysis of the literature about the actual role of SPBx in the repeat setting. Materials and Methods: We performed a systematic review of the literature since 1995 up to 2011. Electronic searches were limited to the English language, using the MEDLINE database. The key words ‘saturation prostate biopsy’ and ‘repeated prostate biopsy’ were used. Results: SPBx improves PCa DR if clinical suspicion persists after previous biopsy with negative findings and provides an accurate prediction of prostate tumor volume and grade, even if the issue about the number and locations of the cores is still a matter of debate. Conclusions: At present, SPBx seems to be really necessary in men with persistent suspicion of PCa after negative initial biopsy and probably in patients with a multifocal high-grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. In the remaining situations, adopting an individualized scheme is preferable.

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Section: Resultsmentioning

confidence: 99%

“…SPBx has proved to be useful when focal therapy is considered, but only when compared with fewer EPBx schemes [44,47,50,51,52,62,63,64,65,66]. Unfortunately, even SPBx has been proven not to be sufficiently accurate in the evaluation of the laterality and extension of the tumor.…”

Section: Resultsmentioning

confidence: 99%

Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

et al. 2012

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“…As a result, an optimal biopsy strategy includes an adequate number of cores to provide confidence in a negative finding while limiting the number of cores and pathologic specimens sufficiently to avoid over-detection and cost escalation. Consequently, today’s biopsy protocols typically involve extracting 10–12 cores per biopsy, 1 which has been endorsed by expert panels in the United States, Canada, and Italy. 2–4 No consensus exists regarding the optimal labeling of these prostate biopsy cores for pathologic processing or the number of allowable cores per container without compromise of histologic evaluation.…”

Section: Introductionmentioning

confidence: 99%

“…2–4 No consensus exists regarding the optimal labeling of these prostate biopsy cores for pathologic processing or the number of allowable cores per container without compromise of histologic evaluation. Given the controversy regarding the optimal strategy for prostate biopsy with regard to core number, location, labeling, and pathologic processing 1, 3 , we undertook a review of the literature to address the following primary objectives:…”

Section: Introductionmentioning

confidence: 99%

Optimization of Initial Prostate Biopsy in Clinical Practice: Sampling, Labeling and Specimen Processing

Carter²,

et al. 2013

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Purpose An optimal prostate biopsy in clinical practice is based on a balance between adequate detection of clinically significant prostate cancers (sensitivity), assuredness regarding the accuracy of negative sampling (negative predictive value [NPV]), limited detection of clinically insignificant cancers, and good concordance with whole-gland surgical pathology results to allow accurate risk stratification and disease localization for treatment selection. Inherent within this optimization is variation of the core number, location, labeling, and processing for pathologic evaluation. To date, there is no consensus in this regard. The purpose of this review is 3-fold: 1. To define the optimal number and location of biopsy cores during primary prostate biopsy among men with suspected prostate cancer, 2. To define the optimal method of labeling prostate biopsy cores for pathologic processing that will provide relevant and necessary clinical information for all potential clinical scenarios, and 3. To determine the maximal number of prostate biopsy cores allowable within a specimen jar that would not preclude accurate histologic evaluation of the tissue. Materials and Methods A bibliographic search covering the period up to July, 2012 was conducted using PubMed®. This search yielded approximately 550 articles. Articles were reviewed and categorized based on which of the three objectives of this review was addressed. Data was extracted, analyzed, and summarized. Recommendations based on this literature review and our clinical experience is provided. Results The use of 10–12-core extended-sampling protocols increases cancer detection rates (CDRs) compared to traditional sextant sampling methods and reduces the likelihood that patients will require a repeat biopsy by increasing NPV, ultimately allowing more accurate risk stratification without increasing the likelihood of detecting insignificant cancers. As the number of cores increases above 12 cores, the increase in diagnostic yield becomes marginal. Only limited evidence supports the use of initial biopsy schemes involving more than 12 cores or saturation. Apical and laterally directed sampling of the peripheral zone increases CDR, reduces the need for repeat biopsies, and predicts pathological features on prostatectomy while transition-zone biopsies do not. There is little data to suggest that knowing the exact site of an individual positive biopsy core provides meaningful clinical information. However, determining laterality of cancer on biopsy may be helpful for both predicting sites of extracapsular extension and therapeutic planning. Placement of multiple biopsy cores in a single container (>2) appears to compromise pathologic evaluation, which can reduce CDR and increase the likelihood of equivocal diagnoses. Conclusions A 12-core systematic biopsy that incorporates apical and far-lateral cores in the template distribution allows maximal cancer detection, avoidance of a repeat biopsy, and adequate information for both identifying men who need therapy and...

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“…Biochemical recurrence is commonly defined as a detectable elevation of Prostate Specific Antigen (PSA), a key biomarker for CaP [26-28]. However, the nonspecificity of PSA leads to over-treatment of CaP, resulting in many unnecessary treatments, which are both stressful and costly [29-33]. Even the most widely used prognostic markers such as pathologist assigned Gleason grade [34], which attempts to capture the morphometric and architectural appearance of CaP on histopathology, has been found to be a less than perfect predictor of biochemical recurrence [35].…”

Section: Introductionmentioning

confidence: 99%

Supervised Regularized Canonical Correlation Analysis: integrating histologic and proteomic measurements for predicting biochemical recurrence following prostate surgery

et al. 2011

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BackgroundMultimodal data, especially imaging and non-imaging data, is being routinely acquired in the context of disease diagnostics; however, computational challenges have limited the ability to quantitatively integrate imaging and non-imaging data channels with different dimensionalities and scales. To the best of our knowledge relatively few attempts have been made to quantitatively fuse such data to construct classifiers and none have attempted to quantitatively combine histology (imaging) and proteomic (non-imaging) measurements for making diagnostic and prognostic predictions. The objective of this work is to create a common subspace to simultaneously accommodate both the imaging and non-imaging data (and hence data corresponding to different scales and dimensionalities), called a metaspace. This metaspace can be used to build a meta-classifier that produces better classification results than a classifier that is based on a single modality alone. Canonical Correlation Analysis (CCA) and Regularized CCA (RCCA) are statistical techniques that extract correlations between two modes of data to construct a homogeneous, uniform representation of heterogeneous data channels. In this paper, we present a novel modification to CCA and RCCA, Supervised Regularized Canonical Correlation Analysis (SRCCA), that (1) enables the quantitative integration of data from multiple modalities using a feature selection scheme, (2) is regularized, and (3) is computationally cheap. We leverage this SRCCA framework towards the fusion of proteomic and histologic image signatures for identifying prostate cancer patients at the risk of 5 year biochemical recurrence following radical prostatectomy.ResultsA cohort of 19 grade, stage matched prostate cancer patients, all of whom had radical prostatectomy, including 10 of whom had biochemical recurrence within 5 years of surgery and 9 of whom did not, were considered in this study. The aim was to construct a lower fused dimensional metaspace comprising both the histological and proteomic measurements obtained from the site of the dominant nodule on the surgical specimen. In conjunction with SRCCA, a random forest classifier was able to identify prostate cancer patients, who developed biochemical recurrence within 5 years, with a maximum classification accuracy of 93%.ConclusionsThe classifier performance in the SRCCA space was found to be statistically significantly higher compared to the fused data representations obtained, not only from CCA and RCCA, but also two other statistical techniques called Principal Component Analysis and Partial Least Squares Regression. These results suggest that SRCCA is a computationally efficient and a highly accurate scheme for representing multimodal (histologic and proteomic) data in a metaspace and that it could be used to construct fused biomarkers for predicting disease recurrence and prognosis.

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Extended and saturation needle biopsy for the diagnosis of prostate cancer

Cited by 25 publications

References 51 publications

Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

Optimization of Initial Prostate Biopsy in Clinical Practice: Sampling, Labeling and Specimen Processing

Supervised Regularized Canonical Correlation Analysis: integrating histologic and proteomic measurements for predicting biochemical recurrence following prostate surgery

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