Saturation prostate needle biopsy and prostate cancer detection at initial and repeat evaluation

Area of Science:

• Urology
• Oncology
• Diagnostic Imaging

Background:

• Prostate cancer (PCa) diagnosis relies heavily on prostate biopsy.
• Saturation prostate biopsy (SPBx) involves a higher number of tissue cores.
• The efficacy of SPBx as a primary or repeat biopsy strategy requires evaluation.

Purpose of the Study:

• To assess the prostate cancer (PCa) detection rate using saturation prostate biopsy (SPBx).
• To compare SPBx efficacy as a primary diagnostic tool versus repeat biopsy.
• To evaluate SPBx performance against standard 12- and 18-core biopsy protocols.

Main Methods:

• 189 patients underwent transrectal ultrasound-guided SPBx (median 29 cores).
• SPBx was performed as primary (98 patients), second (75), or third (16) biopsy.
• SPBx results were compared retrospectively with 12-core (256 patients) and 18-core (116 patients) primary biopsies, and 18-core (73 patients) rebiopsies.

Main Results:

• As a primary biopsy, SPBx detected PCa in 46.9% of cases, compared to 39.8% (12-core) and 49% (18-core).
• For rebiopsy, SPBx detected PCa in 22% of second biopsies and 6.2% of third biopsies, significantly higher than 18-core rebiopsy rates (10.9% and 0%, respectively).
• Neoplastic microfoci incidence was 34.7% on first biopsy and 45.5% on second biopsy.

Conclusions:

• Saturation prostate biopsy (SPBx) is not superior to an 18-core scheme for primary prostate cancer detection.
• SPBx is a recommended method for repeat prostate biopsies, effectively doubling PCa detection rates.
• Clinically significant cancer was confirmed in radical prostatectomy specimens following SPBx diagnosis of neoplastic microfoci.