What is the ideal core number for ultrasound-guided prostate biopsy? - Abstract

PURPOSE: We evaluated the utility of 10-, 12-, and 16-core prostate biopsies for detecting prostate cancer (PCa) and correlated the results with prostate-specific antigen (PSA) levels, prostate volumes, Gleason scores, and detection rates of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP).

MATERIALS AND METHODS:A prospective controlled study was conducted in 354 consecutive patients with various indications for prostate biopsy. Sixteen-core biopsy specimens were obtained from 351 patients. The first 10-core biopsy specimens were obtained bilaterally from the base, middle third, apex, medial, and latero-lateral regions. Afterward, six additional punctures were performed bilaterally in the areas more lateral to the base, middle third, and apex regions, yielding a total of 16-core biopsy specimens. The detection rate of carcinoma in the initial 10-core specimens was compared with that in the 12- and 16-core specimens.

RESULTS: No significant differences in the cancer detection rate were found between the three biopsy protocols. PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798). The 10-, 12-, and 16-core protocols were compared with stratified PSA levels, stratified prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP; no significant differences were found.

CONCLUSIONS: Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy.

Written by:
Chambó RC, Tsuji FH, de Oliveira Lima F, Yamamoto HA, Nóbrega de Jesus CM.   Are you the author?
Graduate in Base of Surgery Program, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil; Department of Pathology, Hospital das Clinicas, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil; Department of Urology, Hospital das Clinicas, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.

Reference: Korean J Urol. 2014 Nov;55(11):725-31.
doi: 10.4111/kju.2014.55.11.725


PubMed Abstract
PMID: 25405014

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