Journal of Korean Society of Ultrasound in Medicine 2012;31(3): 167-173.
Medially Directed TRUS Biopsy of the Prostate: Clinical Utility and Optimal Protocol.
Byung Kwan Park, Seung Hyup Kim
1Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. kimsh@radcom.snu.ac.kr
2Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  Published online: September 26, 2012.
ABSTRACT
PURPOSE: The objective of this study is to determine whether medially directed transrectal ultrasound (TRUS)-guided biopsy is necessary for detection of prostate cancer and for establishment of an optimal biopsy regimen tha is equivalent to a systematic 12 core biopsy. MATERIALS AND METHODS: A total of 302 patients underwent a TRUS-guided systematic 12 core biopsy consisting of both medial sextant biopsy obtained between the parasagittal line and midline and lateral sextant biopsy obtained between the parasagittal line and lateral border. We obtained cancer detection rates of various biopsy regimens that were produced from a systematic 12 core biopsy. RESULTS: Using a systematic 12 core biopsy, cancer was detected in 116 (38.4%) of 302 patients. No significant difference was observed between cancer detection rates of medial sextant biopsy and lateral sextant biopsy (33.8% versus 31.5%, p >.05). Biopsy regimens that were equivalent to the systematic 12 core regarding cancer detection rate included medially directed cores that were obtained from both medial portions of the apex. CONCLUSION: Both medially directed biopsy and laterally directed biopsy are necessary for detection of prostate cancer and for establishment of an optimal biopsy regimen.
Keywords: Ultrasound; Biopsy; Prostate; Prostate neoplasm
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