Repeat Prostate Biopsy: Rationale, Indications, and Strategies

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Prostate biopsy (PB) inaccuracy necessitates repeat biopsy (RB) for accurate prostate cancer (PCa) detection and characterization.
• RB is increasingly utilized in clinical practice for PCa management.

Purpose of the Study:

• To review current data on the indications, techniques, and clinical implications of repeat prostate biopsy (RB).
• To provide a comprehensive overview of RB in the context of prostate cancer diagnosis and surveillance.

Main Methods:

• Systematic literature search of Medline, PubMed, and Scopus for articles published between 2008 and 2014.
• Screening, data extraction, and synthesis of relevant abstracts addressing the role of RB in PCa.

Main Results:

• RB is indicated for persistent PCa suspicion post-negative biopsy or during active surveillance (AS).
• Magnetic resonance imaging (MRI)-guided RB offers improved accuracy in PCa detection and characterization.
• Multiple RBs require careful evaluation due to potential complications, particularly infection.

Conclusions:

• RB indications and techniques must adapt to advancements in imaging and evolving PCa management strategies.
• MRI-guided targeted biopsy improves PCa detection accuracy without substantially increasing the detection of low-risk disease.
• Specialized centers offer rationalized management for persistent PCa suspicion, optimizing RB indications, techniques, and clinical outcomes.