Incremental detection rate of prostate cancer by real‐time elastography targeted biopsies in combination with a conventional 10‐core biopsy in 1024 consecutive patients. (14th February 2014)

• Record Type: Journal Article
• Authors: Salomon, Georg; Drews, Nils; Autier, Philippe; Beckmann, Ann; Heinzer, Hans; Hansen, Jens; Michl, Uwe; Schlomm, Thorsten; Haese, Alex; Steuber, Thomas; Graefen, Markus; Becker, Andreas
• Is Part Of: BJU international. Volume 113:Number 4(2014:Apr.)
• Page Start: 548
• Page End: 553
• Publication Date: 2014-02-14
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12517
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12517-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12517-list-0001" list-type="bullet"> <list-item> <p>To quantify the incremental detection rate (DR) of a targeted biopsy in addition to a randomized 10‐core biopsy.</p> </list-item> </list> </p> </sec> <sec id="bju12517-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p> <list id="bju12517-list-0002" list-type="bullet"> <list-item> <p>This retrospective study analysed 1024 patients who consecutively underwent a four‐core real‐time elastography (RTE) targeted biopsies in addition to a randomized 10‐core transrectal ultrasonography (TRUS)‐guided biopsy in a primary or rebiopsy setting.</p> </list-item> <list-item> <p>The overall DR, the DR of a 10‐core randomized, RTE targeted biopsy and the incremental DR were calculated.</p> </list-item> </list> </p> </sec> <sec id="bju12517-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12517-list-0003" list-type="bullet"> <list-item> <p>Overall, randomized and RTE targeted biopsy DRs (for the combination, the 10‐core and the four‐core RTE biopsy scheme) were 46.2% (<italic>n</italic> = 473), 39.1% (<italic>n</italic> = 400) and 29.0% (<italic>n</italic> = 297), respectively.</p> </list-item> <list-item> <p>Four‐core RTE targeted biopsies detected an additional 73 patients not detected by the 10‐core randomized biopsies (increase in the overall DR of 7.1%). This represented a relative increase in DR of 18.3%. The incremental DR was better in rebiopsy patients (24.8%) than in patients having their first biopsy (14.7%).</p> </list-item> <list-item> <p>Within all patients diagnosed by RTE targeted biopsy only, 34 patients harboured significant Gleason 4 or 5 prostate cancer (PCa), diagnosed by four‐core RTE biopsy only. Moreover, PCa with a Gleason grade of 4 or 5 was detected by four‐core RTE biopsies in 30 patients, who showed low‐grade PCa ≤ Gleason 3 only in the systematic 10‐core biopsy.</p> </list-item> </list> </p> </sec> <sec id="bju12517-sec-0004" sec-type="section"> <title>Conclusions</title> <p> <list id="bju12517-list-0004" list-type="bullet"> <list-item> <p>Real‐time elastography targeted biopsy seems to be an appropriate method for increasing the DR of PCa.</p> </list-item> <list-item> <p>Nevertheless, RTE targeted biopsies missed a high proportion of patients with PCa and should therefore be considered as an addition to randomized biopsies.</p> </list-item> </list> </p> </sec> </abstract>