Our Summary

This study was carried out to compare the effectiveness of different ways to detect prostate cancer. Researchers looked at two methods: traditional biopsies (SB), where samples are taken from different areas of the prostate, and targeted biopsies (TB), guided by a mix of MRI and ultrasound imaging. They wanted to see which was best at finding cancer in men who had never had a biopsy before, and in those who had previous negative biopsies.

The team examined records from over 500 patients who had undergone both types of biopsies between December 2015 and June 2019. They found that cancer was detected in around 57% of these patients, with a higher detection rate in those having their first biopsy compared to those who had had biopsies before.

When they looked at the detection rates for each method on its own, both types of biopsy had similar success rates, but neither was as good as when the two methods were combined. This was confirmed when they compared the biopsy results with the findings from surgery. Of the 118 patients who had surgery, 23 would have been missed if they had only had a TB and 14 would have been missed if they had only had an SB.

In conclusion, the researchers suggest that both methods should be used together for the best chance of detecting prostate cancer.

FAQs

  1. What were the detection rates for prostate cancer with systematic 10-core biopsies and targeted biopsies?
  2. How were the prostate cancer detection rates compared between biopsy-naïve patients and those with previous biopsies?
  3. Why should systematic 10-core biopsies not be omitted in prostate cancer detection?

Doctor’s Tip

A helpful tip a doctor might tell a patient about prostate biopsy is to consider a combination of targeted biopsies guided by magnetic resonance imaging (MRI) and traditional systematic biopsies for higher detection rates of clinically significant prostate cancer. It is important not to rely solely on one type of biopsy, as the combination of both methods can provide a more accurate assessment of the presence of cancer. It is also important to discuss the findings with your doctor and consider all available options for further treatment or monitoring.

Suitable For

Patients who are typically recommended for prostate biopsy include those with prostate imaging-reporting and data system lesions grade ≥ 3, patients who have had previously negative prostate biopsies, and patients with suspected or elevated risk for prostate cancer. It is important to consider both systematic 10-core biopsies and targeted biopsies guided by magnetic resonance imaging to ensure a comprehensive assessment for prostate cancer detection.

Timeline

Before the prostate biopsy:

  1. Patient undergoes initial consultation with urologist to discuss symptoms and risk factors for prostate cancer.
  2. Patient may undergo digital rectal exam to assess the size and shape of the prostate gland.
  3. Patient may undergo a prostate-specific antigen (PSA) blood test to measure levels of a protein produced by the prostate gland.
  4. Patient may undergo a transrectal ultrasound (TRUS) to visualize the prostate gland and identify any suspicious areas.
  5. Patient may undergo a magnetic resonance imaging (MRI) scan to further evaluate any suspicious areas detected on TRUS.
  6. Patient may discuss biopsy options with urologist, including systematic 10-core biopsies and targeted biopsies guided by MRI/US fusion imaging.

After the prostate biopsy:

  1. Patient may experience discomfort or pain during and after the biopsy procedure.
  2. Patient may have blood in the urine or semen for a few days after the biopsy.
  3. Patient may be prescribed antibiotics to prevent infection.
  4. Pathology results from the biopsy are analyzed to determine if cancer cells are present.
  5. Depending on the biopsy results, patient may undergo further tests or treatments, such as additional biopsies, prostate cancer staging, or treatment options like surgery, radiation therapy, or active surveillance.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a prostate biopsy?
  2. How accurate are the results of a prostate biopsy in detecting prostate cancer?
  3. What is the difference between a systematic 10-core biopsy and a targeted biopsy guided by MRI/US fusion imaging?
  4. Why is it important to combine both systematic and targeted biopsies for prostate cancer detection?
  5. How will the results of the biopsy impact my treatment options and prognosis?
  6. How soon can I expect to receive the results of the biopsy?
  7. Are there any alternative diagnostic tests or procedures that could be considered instead of a prostate biopsy?
  8. What factors might influence the decision to undergo a prostate biopsy in my specific case?
  9. What is the protocol for follow-up care after a prostate biopsy, regardless of the results?
  10. Are there any lifestyle changes or precautions I should take before or after the biopsy procedure?

Reference

Authors: Lodeta B, Trkulja V, Kolroser-Sarmiento G, Jozipovic D, Salmhofer A, Augustin H. Journal: Int Urol Nephrol. 2021 Nov;53(11):2251-2259. doi: 10.1007/s11255-021-02989-2. Epub 2021 Sep 9. PMID: 34505227