2221 VERIFICATION OF TRADITIONAL EXTENDED SEXTANT 12 CORE TRUS PROSTATE BIOPSY LOCATIONS (2013)

You have accessJournal of UrologyProstate Cancer: Detection & Screening (V)1 Apr 20132221 VERIFICATION OF TRADITIONAL EXTENDED SEXTANT 12 CORE TRUS PROSTATE BIOPSY LOCATIONS Srinivas Vourganti, Jennifer Logan, Soroush Rais-Bahrami, M.Minhaj Siddiqui, Lambros Stamatakis, Annerleim Walton-Diaz, Anthony Hoang, Jeffrey Nix, Colette Harris, Hong Truong, Todd Sterling, Jochen Kruecker, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter A Pinto Srinivas VourgantiSrinivas Vourganti Bethesda, MD , Jennifer LoganJennifer Logan Bethesda, MD , Soroush Rais-BahramiSoroush Rais-Bahrami Bethesda, MD , M.Minhaj SiddiquiM.Minhaj Siddiqui Bethesda, MD , Lambros StamatakisLambros Stamatakis Bethesda, MD , Annerleim Walton-DiazAnnerleim Walton-Diaz Bethesda, MD , Anthony HoangAnthony Hoang Bethesda, MD , Jeffrey NixJeffrey Nix Bethesda, MD , Colette HarrisColette Harris Bethesda, MD , Hong TruongHong Truong Bethesda, MD , Todd SterlingTodd Sterling Bethesda, MD , Jochen KrueckerJochen Kruecker Bethesda, MD , Baris TurkbeyBaris Turkbey Bethesda, MD , Peter ChoykePeter Choyke Bethesda, MD , Bradford WoodBradford Wood Bethesda, MD , and Peter A PintoPeter A Pinto Bethesda, MD View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2130AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Systematic 12-core TRUS prostate biopsy is intended to adequately sample the prostate peripheral zone (PZ). In this study, we used an existing MRI/US fusion platform to electromagnetically track individual random TRUS biopsy locations, providing confirmation of adequate prostate sampling and pathologic correlation with biopsy site. METHODS We studied 102 men who underwent multi-parametric MRI (MP-MRI) prior to random 12-core TRUS biopsy between Jan-Sept 2012. 3D TRUS images were obtained during biopsy using electromagnetic tracking of the needle guide. Location of individual needle passes was recorded and electronically fused with pre-biopsy MRI. Core locations were classified to be in the prostate apex, mid, or base by end-fire US probe in relation to the TRUS bx plane. In addition, the percent of PZ in each core was recorded. Image co-registration errors were not corrected due to software limitations. RESULTS 1,216 individual needle biopsies were reviewed. Needle cores were noted to be in the intended region (base, mid, or apex) in 987 cores (81.2%). Cores directed at the base were significantly less likely to be in the intended region (69.7% vs 86.8%, p<0.0001), as were cores directed at the left prostate (77.7% vs 84.7%, p=0.002). Mean prostate volume was significantly smaller when the target reached its intended region (51.3g vs 55.3g, p=0.0478). Needle cores contained less than 25% PZ in 337 biopsies (27.7%). Mean prostate volume was significantly smaller in cores with at least 25% PZ (46.7g vs 66.1g, p<0.0001). Diagnostic yield was significantly higher in cores with at least 25% PZ (15.02% vs 8.01%, p=0.0009). Cancer containing cores with at least 25% PZ had significantly greater grade (50.8% low grade vs 29.6% low grade, 0.0451). In fact, no high grade cancer was found on cores containing less than 25% PZ. CONCLUSIONS Electromagnetic tracking has allowed assessment of location of random TRUS biopsies. Biopsy quality (assessed by PZ content) is correlated with diagnostic cancer yield and ability to detect high grade disease. Inaccurate biopsy location and inadequate PZ sampling occurred more often in larger prostates, suggesting that random biopsy may be less accurate in men with larger glands. Future refinement of this technology could potentially be used to improve systematic biopsy sampling. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e911 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Srinivas Vourganti Bethesda, MD More articles by this author Jennifer Logan Bethesda, MD More articles by this author Soroush Rais-Bahrami Bethesda, MD More articles by this author M.Minhaj Siddiqui Bethesda, MD More articles by this author Lambros Stamatakis Bethesda, MD More articles by this author Annerleim Walton-Diaz Bethesda, MD More articles by this author Anthony Hoang Bethesda, MD More articles by this author Jeffrey Nix Bethesda, MD More articles by this author Colette Harris Bethesda, MD More articles by this author Hong Truong Bethesda, MD More articles by this author Todd Sterling Bethesda, MD More articles by this author Jochen Kruecker Bethesda, MD More articles by this author Baris Turkbey Bethesda, MD More articles by this author Peter Choyke Bethesda, MD More articles by this author Bradford Wood Bethesda, MD More articles by this author Peter A Pinto Bethesda, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...