The Ratio of the Number of Biopsy Specimens to Prostate Volume (Biopsy Density) Greater Than 1.5 Improves the Prostate Cancer Detection Rate in Men Undergoing Transperineal Biopsy of the Prostate

Stone, Nelson N.; Crawford, E. David; Skouteris, Vassilios; Arangua, Paul; Metsinis, Panagiotis-Marios; Lucia, M. Scott; Rosa, Francisco G. La; Werahera, Priya N.

doi:10.1097/ju.0000000000000204

Cited by 16 publications

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“…However, PSA is secreted by the prostate, and PV size influences the secretion of PSA, thus interfering with prostate cancer diagnosis . Stone et al reported that a ratio of biopsy specimens to PV larger than 1.5 improved the positive rate in men undergoing transperineal biopsy of the prostate, indicating that more biopsy specimens are needed for patients with larger PV.…”

Section: Introductionmentioning

confidence: 99%

Age, height, BMI and FBG predict prostate volume in ageing benign prostatic hyperplasia: Evidence from 5285 patients

et al. 2019

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Aims Several studies have reported a potential association between prostate volume (PV) and prostate disease. Here, we classified the risk factors for PV among benign prostatic hyperplasia (BPH) patients. Methods In all, 4293 BPH patients with available clinical information were enrolled. Body mass index (BMI) was obtained as weight divided by height squared. PV was calculated as length × width × height (cm) × π/6. Mann‐Whitney U tests were used to determine the differences between PV subgroups. Univariate and multiple linear regression tests were performed to uncover the connection between clinical features and PV. The differences in the age, BMI, height and fasting blood glucose (FBG) of the subgroups were evaluated by Kruskal‐Wallis tests and adjusted with Bonferroni post hoc correction. A nomogram was created to directly illustrate the mutual interaction of amalgamator parameters. Results PV did not influence the incidence of kidney stones (P = .815), whereas prostate calculi were positively associated with an enlarged prostate (>30 mL) (P < .001). Age (adjusted R = 0.363, P < .001), height (adjusted R = 0.088, P < .001), BMI (adjusted R = 0.039, P = .013) and FBG (adjusted R = −0.034, P = .027) were the independent risk/protective factors related to enlarged PV among BPH patients. The nomogram illustrated the predictive risk of an enlarged prostate (>30 mL) in men. The area under the ROC curve value was 0.659 in the training cohort and 0.677 in an internal validation cohort. Conclusions Age, height and BMI were positive independent risk factors of enlarged PV in BPH patients, and FBG had a protective role.

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Section: Introductionmentioning

confidence: 99%

Age, height, BMI and FBG predict prostate volume in ageing benign prostatic hyperplasia: Evidence from 5285 patients

et al. 2019

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“…One patient had 169 biopsies taken at TPMB and had a prostate volume of 69 cc. His biopsy density was 2.4 and based on a recent publication that number could have been reduced to 1.5, which would have decreased the number of cores to 104 10 . His PSAD was 0.87, and the mpMRI was negative.…”

Section: Discussionmentioning

confidence: 99%

Transperineal prostate biopsy identifies locations of clinically significant prostate cancer in men considering focal therapy with PI‐RADS 3–5 regions of interest

et al. 2021

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Objectives To determine the benefit of performing transperineal prostate mapping biopsy (TPMB) following multiparametric magnetic resonance imaging (mpMRI) to increase the identification of clinically significant prostate cancer (csPCa) with Gleason grade group (GG) ≥ 2 and their locations outside of the PI‐RADS v2 3–5 category lesions. Methods mpMRI was performed in 80 men prior TPMB from two institutions. The mpMRI was considered clinically significant (csMRI) if it contained one or more PI‐RADS 3–5 category lesion. mpMRI findings were compared against csPCa diagnosed by TPMB, performed between 16 November 2010, and 13 September 2019, for the entire gland, both lobes and to the right and left anterior and right and left posterior quadrants (RA, LA, RP and LP). Sensitivity, specificity, positive and negative predictive values (PPV, NPV), accuracy and the area under curve (AUC) were determined. Thirteen men also underwent radical prostatectomy and had comparison of TPMB pathology to prostatectomy specimen grading. Results TPMB was positive in 60/80 (75%) of which 32 (53.3%) were csPCa. csPCa was present in the RA in 9 (11.3%), LA in 11 (13.8%), RP in 25 (31.3%) and LP in 27 (33.8%) and involved 1 quadrant in 7 (21.9%), 2 quadrants in 12 (37.5%), 3 quadrants in 11 (34.4%) and all 4 quadrants in 2 (6.3%) patients; 57/80 (71.3%) men had a mpMRIs with lesions designated as PI‐RADS 3 in 24 (30%), 4 in 25 (31.3%) and 5 in 8 (10%). A csMRI was present in the RA in 7 (8.8%), LA in 8 (10%), RP in 31 (38.8%) and in the LP in 29 (36.3%), which were limited to one quadrant in 39 (68.4%), 2 quadrants in 16 (28.1%), and 3 quadrants in 2 (3.5%). Sensitivity, specificity, PPV, and NPV were determined from the results of the TPMB and were for the entire gland 81.3%, 35.4%, 45.6% and 73.9%. There were 31 csMRIs involving the right posterior of the gland but only 25 csPCa by TPMB of which 12/31 (38.7%) were concordant for high grade disease. There were 29 men who have a csMRI in the left posterior quadrant, and 14 (48.3%) were concordant with csPCa from the TPMB. Conclusions MpMRI should be supplemented with TPMB to correctly identify the regions of the prostate that would require ablation in men considering focal therapy.

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“…Targeted biopsies do add additional information using conventional systematic biopsy methods [ 23 ], and this result is confirmed in the initial biopsy setting by a prospective multicenter trial [ 24 ]. With regard to the prostate volume, there are also reports that biopsy density is relevant in the prostate cancer detection rate [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

Lee

Choi

Sung

et al. 2021

JCM

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Background: To identify the role of combination biopsy, which consists of both targeted and additional systematic cores, in the diagnosis of clinically significant prostate cancer (csPCa). Methods: We retrospectively reviewed patients with PSA levels 2.5–15 ng/mL who have a suspicious prostate lesion (with the Prostate Imaging Reporting and Data System (PI-RADS) ≥ 3) on multiparametric MRI (mpMRI) between January 2016 and December 2018. We analyzed biopsy results by PI-RADS score and biopsy methods (systematic, targeted, and combination biopsy). Results: Of the 711 total patients, an average of 4.0 ± 1.8 targeted and 8.6 ± 3.1 additional systematic biopsies were performed. The additional systematic biopsies were sampled outside the targeted biopsy area. The combination biopsies detected more csPCa (201 patients, 28.3%) than did the targeted (175 patients, 24.6%) or systematic (124 patients, 17.4%) biopsies alone (p < 0.001). In the initial biopsy samples, there was a 7% increase in the detection of csPCa than in targeted biopsy (62% to 69%). It increased by 11% in repeat biopsy (46% to 57%). There was no statistical significance in both groups (p = 0.3174). Conclusions: Combination biopsy has the benefit of detecting csPCa in both initial and repeat biopsy when there is a suspicious lesion on mpMRI.

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The Ratio of the Number of Biopsy Specimens to Prostate Volume (Biopsy Density) Greater Than 1.5 Improves the Prostate Cancer Detection Rate in Men Undergoing Transperineal Biopsy of the Prostate

Cited by 16 publications

References 0 publications

Age, height, BMI and FBG predict prostate volume in ageing benign prostatic hyperplasia: Evidence from 5285 patients

Age, height, BMI and FBG predict prostate volume in ageing benign prostatic hyperplasia: Evidence from 5285 patients

Transperineal prostate biopsy identifies locations of clinically significant prostate cancer in men considering focal therapy with PI‐RADS 3–5 regions of interest

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

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