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

Abstract

BackgroundWe 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.MethodsIn 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.ResultsThe 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%).ConclusionsTransperineal 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.

Atypical small acinar proliferation and two or more cores of high-grade intraepithelial neoplasia on a previous prostate biopsy are significant predictors of cancer during a transperineal template-guided saturation biopsy aimed at sampling one core for each 1 mL of prostate volume

“…This number is the highest among all reports about TTSB. 18 Lee et al 20 reported that a high number of cores predicts PCa in patients who were diagnosed with HGPIN at a previous biopsy. These facts may contribute to the high detection rate of PCa in patients who had two or more cores of HGPIN at a previous TRUS-guided biopsy.…”

“…We previously reported on the TTSB method that we used in this study. 18 A transrectal probe (Toshiba Medical, Tochigi, Japan) that was attached to a brachytherapy stepping unit (AccuSeed, Bedfordshire, UK) was inserted into the rectum. The low-echoic area was estimated, and the prostate volume was calculated by using the following formula: length × width × height × 0.5236.…”

“…Therefore, there is not enough evidence to support the use of saturation biopsy for HGPIN and ASAP. In a previous study, we conducted a saturation biopsy that required one biopsy core per milliliter of prostate volume, 18 and we showed that there was a high mean number of biopsy cores per unit prostate volume of 1.06 core/mL. With this method, we can obtain a sufficient sample and precise diagnosis.…”

Needle Biopsy Adequacy in the Era of Precision Medicine and Value-Based Health Care

“…257 The extensive histologic heterogeneity as measured by Gleason score differences within an individual cancer mandates multiple sampling of tumor at the same procedure, 258 at times using a saturation technique, extending to 12 or more needle biopsies. 258,259 To enhance adequacy, much effort has been made to improve the approach route for needle biopsy 260,261 and, in needle design, to increase core length. 255 Accuracy of needle targeting is affected by mode of imaging guidance 262 and by tip deflection, which in turn is affected by prostate size and tissue texture.…”

Previous, Current, and Future Pharmacotherapy and Diagnosis of Prostate Cancer—A Comprehensive Review

“…A special template with holes is placed on the perineum, then needles go through it into the prostate gland [32,35]. In this method, number of cores depends on the gland volume [36]. Whereas during targeted biopsy the MRI scan is used and, as a result, fewer samples are taken.…”