Standards for prostate biopsy

Marc A. Bjurlin, Samir S. Taneja

    Research output: Contribution to journalReview articlepeer-review

    Abstract

    Purpose Of review: A variety of techniques have emerged for the optimization of prostate biopsy. In this review, we summarize and critically discuss the most recent developments regarding the optimal systematic biopsy and sampling labeling along with multiparametric MRI and magnetic resonance-targeted biopsies. Recent findings: The use of 10-12-core-extended sampling protocols increases cancer detection rates compared with traditional sextant sampling and reduces the likelihood that patients will require a repeat biopsy, ultimately allowing more accurate risk stratification without increasing the likelihood of detecting insignificant cancers. As the number of cores increases above 12 cores, the increase in diagnostic yield becomes marginal. However, the limitations of this technique include undersampling, oversampling, and the need for repetitive biopsy. MRI and magnetic resonance-targeted biopsies have demonstrated superiority over systematic biopsies for the detection of clinically significant disease and representation of disease burden, while deploying fewer cores and may have applications in men undergoing initial or repeat biopsy and those with low-risk cancer on or considering active surveillance. SUMMARY: A 12-core systematic biopsy that incorporates apical and far-lateral cores in the template distribution allows maximal cancer detection, avoidance of a repeat biopsy while minimizing the detection of insignificant prostate cancers. MRI-guided prostate biopsy has an evolving role in both initial and repeat prostate biopsy strategies, as well as active surveillance, potentially improving sampling efficiency, increasing the detection of clinically significant cancers, and reducing the detection of insignificant cancers.

    Original languageEnglish (US)
    Pages (from-to)155-161
    Number of pages7
    JournalCurrent Opinion in Urology
    Volume24
    Issue number2
    DOIs
    StatePublished - Mar 2014

    Keywords

    • MR-targeted biopsy
    • magnetic resonance-ultrasound fusion
    • multiparametric MRI
    • prostate biopsy
    • visual estimation transrectal ultrasound-guided biopsy

    ASJC Scopus subject areas

    • Urology

    Fingerprint

    Dive into the research topics of 'Standards for prostate biopsy'. Together they form a unique fingerprint.

    Cite this