True targeting-derived prostate biopsy: HistoScanning™ remained inadequate despite advanced technical efforts.

To verify the reliability of HistoScanning™-based, true targeting (TT)-derived prostate biopsy.

We relied on 40 patients suspicious for prostate cancer who underwent standard and TT-derived prostate biopsy.

Sensitivity, specificity, positive predictive value, negative predictive value and the area under the curve (AUC) were assessed for the prediction of biopsy results per octant by HistoScanning™, using different HistoScanning™ signal volume cutoffs (>0, >0. 2 and >0. 5 ml).

Overall, 319 octants were analyzed. Of those, 64 (20. 1 %) harbored prostate cancer. According to different HistoScanning™ signal volume cutoffs (>0, >0. 2 and >0. 5 ml), the AUCs for predicting biopsy results were: 0. 51, 0. 51 and 0. 53, respectively. Similarly, the sensitivity, specificity, positive predictive and negative predictive values were: 20. 7, 78. 2, 17. 4 and 81. 6 %; 20. 7, 82. 0, 20. 3 and 82. 3 %; and 12. 1, 94. 6, 33. 3 and 82. 9 %, respectively.

Prediction of biopsy results based on HistoScanning™ signals and TT-derived biopsies was unreliable. Moreover, the AUC of TT-derived biopsies was low and did not improve when additional signal volume cutoffs were applied (>0. 2 and >0. 5 ml). We cannot recommend a variation of well-established biopsy standards or reduction in biopsy cores based on HistoScanning™ signals.

World journal of urology. 2015 Jul 28 [Epub ahead of print]

Jonas Schiffmann, Gisa Mehring, Pierre Tennstedt, Lukas Manka, Katharina Boehm, Sami-Ramzi Leyh-Bannurah, Pierre I Karakiewicz, Peter Hammerer, Markus Graefen, Georg Salomon

Department of Urology, Academic Hospital Braunschweig, Salzdahlumerstrasse 90, 38126, Brunswick, Germany, schiffmann.  



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