Objectives: To explore the best individualized systematic prostate biopsy method.
Methods: We retrospectively analyzed the clinical data of 1211 patients who underwent 12-core systematic prostate biopsy guided by transrectal ultrasound from January 2011 to March 2018. Other biopsy core methods (6-, 8-, and 10-core) were estimated from the 12-core biopsy that was performed. Differences in the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (csPCa) were compared.
Results: A total of 498 cases of PCa (41.1%) were detected, and 423 cases (34.9%) were csPCa. There was no significant difference between the 12- and 10-core prostate biopsy strategies in the total detection rates of PCa and csPCa (P > .05). In the subgroup of patients with a maximal prostate cross-sectional area of less than 15 cm2 , there was a significant difference between the 12-core method and the standard 6-core method (P = .03) but no significant differences between the other methods in the detection rate of PCa (P > .05), but in the detection rate of csPCa, the 12-core method differed significantly from the other methods (P = .02-.04) except for the 10-core method (P > .05). In patients with a prostate-specific antigen concentration of 20 ng/mL or higher, there were no significant differences between the 12-core method and all of the other methods (P > 0.05). In patients younger than 70 years and 70 years or older, the 12-core method differed significantly from the other methods (P < .01-.03) except for the 10-core method (P > .05).
Conclusions: Ten- or 12-core biopsy showed a higher detection rate than the other schemes. However, for patients with a prostate-specific antigen concentration of 20 ng/mL or higher, the 6-core systematic biopsy is preferred.
Keywords: biopsy; prostatic neoplasm; transrectal; ultrasound.
© 2018 by the American Institute of Ultrasound in Medicine.