ORLANDO, FL USA (UroToday.com) - There are three systematic biopsy approaches for prostate biopsies: transrectal, parallel needle transperineal, and angled needle transperineal. The detection of significant and insignificant prostate cancer is important in clinical practice. Doyoung Chang and colleagues evaluated and compared the best probability of detection of the 3 methods using different numbers of cores.
The researchers used the Visible Human Project (National Library of Medicine) to simulate transrectal ultrasound guided prostate biopsy. Using Amira Visualization platform, manual segmentation of the whole pelvic structures was performed. The probability of detection for multiple cores was defined as the ratio of the combined volume of individual sampled volumes to the total prostate volume. The authors then compared the maximum probability of detection for different cores and for the mentioned 3-biopsy approaches.
More core sampling led to higher probability of detection of significant tumors if the cores remained the same. The probability of detection was higher when transrectal or angled needle transperineal biopsy was employed. The ratio of significant to insignificant probability of detection decreased as more cores were used.
The authors concluded that cancer probability of detection increases for both large and small lesions. Thus, the increased number of cores leads to prostate cancer over detection. Increased detection of prostate cancer may not be useful in patients who have multiple comorbidities given their chances of death from other causes. Thus, implementation of this technique in a clinical setting may benefit patients who are younger and have fewer comorbidies.
Presented by Doyoung Chang at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
Baltimore, MD USA
Written by Garen Abedi, MD, University of California (Irvine), and medical writer for UroToday.com