Diagnostic performance of a random versus lesion-directed biopsy of the prostate from transrectal ultrasound

Results of a 5-year consecutive clinical study in 1 institution in south Taiwan

Shih Kai Lan, Yuh-Shyan Tsai, Yi Hsiang Lin, Tzong Shin Tzai

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective. The purpose of this study was to compare cancer detection rates of sonographically suspicious lesion-directed biopsies and random biopsies through transverse examination of prostate halves in 518 patients over 5 years. Methods. From 1998 to 2002, 518 patients were referred for prostate biopsies because of either elevated prostate-specific antigen (PSA) levels or abnormal digital rectal examination findings. On the basis of transverse examination of prostate halves by transrectal ultrasound, we performed lesion-directed biopsy of 3 to 5 cores if morphologically suspicious lesions existed on sonography or random biopsy of 3 cores if no obvious suspicious lesions existed. Biopsy specimens were put into 2 labeled containers. Pathologic results were correlated with random and lesion-directed guided locations. Results. Nine-hundred fifty-nine results were obtained from 439 random and 520 lesion-directed biopsies in 518 patients. Cancer was detected in 207 patients (40.7%). Patients with cancer who had PSA levels of 10.0 ng/mL or greater had higher proportions of bilateral cancer lesions than those with PSA levels of less than 10 ng/mL (P = 0.03). One hundred ten (25.1%) of 439 normal-appearing halves taken by random biopsy were tumor-positive compared with 200 (38.5%) of 520 biopsies from halves with sonographically suspicious lesions. Regardless of having random or lesion-directed biopsies, patients with PSA levels of 10 ng/mL or greater had higher positive malignancy rates than those with PSA levels of less than 10.0 ng/mL (P < .001). In about 40 patients, a diagnosis was made by random biopsy from halves that were morphologically normal on sonography not by lesion-directed biopsy from tumor-suspicious contralateral halves. Conclusions. Cancer detection rates of lesion-directed biopsies are superior to those of random biopsies regardless of PSA level.

Original languageEnglish
Pages (from-to)11-17
Number of pages7
JournalJournal of Ultrasound in Medicine
Volume26
Issue number1
DOIs
Publication statusPublished - 2007 Jan 1

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Taiwan
Prostate
Biopsy
Prostate-Specific Antigen
Neoplasms
Clinical Studies
Ultrasonography
Digital Rectal Examination

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{382d29d286ce4a359357e314c1629048,
title = "Diagnostic performance of a random versus lesion-directed biopsy of the prostate from transrectal ultrasound: Results of a 5-year consecutive clinical study in 1 institution in south Taiwan",
abstract = "Objective. The purpose of this study was to compare cancer detection rates of sonographically suspicious lesion-directed biopsies and random biopsies through transverse examination of prostate halves in 518 patients over 5 years. Methods. From 1998 to 2002, 518 patients were referred for prostate biopsies because of either elevated prostate-specific antigen (PSA) levels or abnormal digital rectal examination findings. On the basis of transverse examination of prostate halves by transrectal ultrasound, we performed lesion-directed biopsy of 3 to 5 cores if morphologically suspicious lesions existed on sonography or random biopsy of 3 cores if no obvious suspicious lesions existed. Biopsy specimens were put into 2 labeled containers. Pathologic results were correlated with random and lesion-directed guided locations. Results. Nine-hundred fifty-nine results were obtained from 439 random and 520 lesion-directed biopsies in 518 patients. Cancer was detected in 207 patients (40.7{\%}). Patients with cancer who had PSA levels of 10.0 ng/mL or greater had higher proportions of bilateral cancer lesions than those with PSA levels of less than 10 ng/mL (P = 0.03). One hundred ten (25.1{\%}) of 439 normal-appearing halves taken by random biopsy were tumor-positive compared with 200 (38.5{\%}) of 520 biopsies from halves with sonographically suspicious lesions. Regardless of having random or lesion-directed biopsies, patients with PSA levels of 10 ng/mL or greater had higher positive malignancy rates than those with PSA levels of less than 10.0 ng/mL (P < .001). In about 40 patients, a diagnosis was made by random biopsy from halves that were morphologically normal on sonography not by lesion-directed biopsy from tumor-suspicious contralateral halves. Conclusions. Cancer detection rates of lesion-directed biopsies are superior to those of random biopsies regardless of PSA level.",
author = "Lan, {Shih Kai} and Yuh-Shyan Tsai and Lin, {Yi Hsiang} and Tzai, {Tzong Shin}",
year = "2007",
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T1 - Diagnostic performance of a random versus lesion-directed biopsy of the prostate from transrectal ultrasound

T2 - Results of a 5-year consecutive clinical study in 1 institution in south Taiwan

AU - Lan, Shih Kai

AU - Tsai, Yuh-Shyan

AU - Lin, Yi Hsiang

AU - Tzai, Tzong Shin

PY - 2007/1/1

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N2 - Objective. The purpose of this study was to compare cancer detection rates of sonographically suspicious lesion-directed biopsies and random biopsies through transverse examination of prostate halves in 518 patients over 5 years. Methods. From 1998 to 2002, 518 patients were referred for prostate biopsies because of either elevated prostate-specific antigen (PSA) levels or abnormal digital rectal examination findings. On the basis of transverse examination of prostate halves by transrectal ultrasound, we performed lesion-directed biopsy of 3 to 5 cores if morphologically suspicious lesions existed on sonography or random biopsy of 3 cores if no obvious suspicious lesions existed. Biopsy specimens were put into 2 labeled containers. Pathologic results were correlated with random and lesion-directed guided locations. Results. Nine-hundred fifty-nine results were obtained from 439 random and 520 lesion-directed biopsies in 518 patients. Cancer was detected in 207 patients (40.7%). Patients with cancer who had PSA levels of 10.0 ng/mL or greater had higher proportions of bilateral cancer lesions than those with PSA levels of less than 10 ng/mL (P = 0.03). One hundred ten (25.1%) of 439 normal-appearing halves taken by random biopsy were tumor-positive compared with 200 (38.5%) of 520 biopsies from halves with sonographically suspicious lesions. Regardless of having random or lesion-directed biopsies, patients with PSA levels of 10 ng/mL or greater had higher positive malignancy rates than those with PSA levels of less than 10.0 ng/mL (P < .001). In about 40 patients, a diagnosis was made by random biopsy from halves that were morphologically normal on sonography not by lesion-directed biopsy from tumor-suspicious contralateral halves. Conclusions. Cancer detection rates of lesion-directed biopsies are superior to those of random biopsies regardless of PSA level.

AB - Objective. The purpose of this study was to compare cancer detection rates of sonographically suspicious lesion-directed biopsies and random biopsies through transverse examination of prostate halves in 518 patients over 5 years. Methods. From 1998 to 2002, 518 patients were referred for prostate biopsies because of either elevated prostate-specific antigen (PSA) levels or abnormal digital rectal examination findings. On the basis of transverse examination of prostate halves by transrectal ultrasound, we performed lesion-directed biopsy of 3 to 5 cores if morphologically suspicious lesions existed on sonography or random biopsy of 3 cores if no obvious suspicious lesions existed. Biopsy specimens were put into 2 labeled containers. Pathologic results were correlated with random and lesion-directed guided locations. Results. Nine-hundred fifty-nine results were obtained from 439 random and 520 lesion-directed biopsies in 518 patients. Cancer was detected in 207 patients (40.7%). Patients with cancer who had PSA levels of 10.0 ng/mL or greater had higher proportions of bilateral cancer lesions than those with PSA levels of less than 10 ng/mL (P = 0.03). One hundred ten (25.1%) of 439 normal-appearing halves taken by random biopsy were tumor-positive compared with 200 (38.5%) of 520 biopsies from halves with sonographically suspicious lesions. Regardless of having random or lesion-directed biopsies, patients with PSA levels of 10 ng/mL or greater had higher positive malignancy rates than those with PSA levels of less than 10.0 ng/mL (P < .001). In about 40 patients, a diagnosis was made by random biopsy from halves that were morphologically normal on sonography not by lesion-directed biopsy from tumor-suspicious contralateral halves. Conclusions. Cancer detection rates of lesion-directed biopsies are superior to those of random biopsies regardless of PSA level.

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