[Comparison of prostatic biopsy guided or not guided by echography]

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Prostate cancer diagnosis relies on accurate tissue sampling.
• Traditional digital rectal exams and biopsies have limitations in sensitivity.
• Minimizing false negatives is crucial for timely prostate cancer treatment.

Purpose of the Study:

• To compare the diagnostic accuracy of transrectal digitally directed biopsy versus ultrasound-guided perineal biopsy for suspected prostate cancer.
• To evaluate the rate of cytologic false negatives associated with each biopsy technique.
• To assess the concordance between cyto-histologic findings for both methods.

Main Methods:

• A study of 151 patients (mean age 71) with suspected prostate cancer.
• 104 patients underwent transrectal digitally directed prostatic biopsy.
• 47 patients underwent ultrasonically perineal guided prostatic biopsy, with transrectal fine needle aspiration in all patients.

Main Results:

• High cyto-histologic concordance was observed for both methods: 83.6% for transrectal digitally directed biopsy and 78.7% for perineal ultrasonically guided biopsy.
• Ultrasound-guided biopsy demonstrated a lower rate of cytologic false negatives compared to digitally guided biopsy.
• Digitally directed biopsy remains a viable option when ultrasound is unavailable, with a limited error margin.

Conclusions:

• Ultrasound-guided perineal biopsy offers improved accuracy in diagnosing prostate cancer by reducing false negatives.
• Both transrectal and ultrasound-guided biopsies show high concordance, but ultrasound guidance enhances diagnostic precision.
• Clinical suspicion of prostate cancer warrants accurate biopsy; ultrasound guidance is recommended when available.