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Prostate biopsy strategies: past, present, and future
1Section of Urology (112C), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA. mterris@stanford.edu
The Urologic Clinics of North America
|July 12, 2002
Summary
Endorectal sonography has advanced prostate imaging since 1968. Current extended prostate biopsies show declining cancer detection and rising repeat rates, suggesting a future with fewer, smarter biopsies.
Area of Science:
- Urology
- Medical Imaging
Background:
- Endorectal sonography for prostatic imaging, introduced in 1968, became widely accepted by the 1980s.
- Current extended prostate biopsy protocols involve sextant patterns plus anterior and posterolateral sampling.
Purpose of the Study:
- To analyze the evolving landscape of prostate biopsies and imaging.
- To identify trends in cancer detection and repeat biopsy rates.
Main Methods:
- Review of historical developments in endorectal sonography for prostate imaging.
- Analysis of current extended prostate biopsy techniques.
- Evaluation of cancer detection and repeat biopsy rates associated with transrectal ultrasound-guided biopsies.
Main Results:
- The cancer detection rate for transrectal ultrasound-guided prostate biopsies has decreased.
- The repeat biopsy rate for prostate cancer has increased.
- Current extended biopsy protocols may be yielding diminishing returns.
Conclusions:
- There is a need to re-evaluate current prostate biopsy strategies.
- Future approaches will likely involve fewer biopsies guided by more sophisticated systems.
- Optimizing diagnostic yield while minimizing patient burden is crucial.