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3D Image-Guided Mapping Biopsy for Defining Spatial Distribution of Prostate Cancer

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Imaging and Focal Therapy of Early Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Widespread use of PSA screening has dramatically impacted the landscape of prostate cancer diagnosis and treatment. Diagnostic transrectal, ultrasound-guided biopsies of the prostate have improved since their first descriptions, but fall short of offering accurate staging of disease needed to confidently treat single lesions or even rule out more advanced disease. Three-dimensional mapping or staging biopsies (3DMB), performed using a template to guide biopsy needles through the perineum rather than transrectally, offer the possibility of more accurate stage, grade, tumor size, and location than standard diagnostic biopsy schemes in select patients. In this chapter, we present the background of prostate biopsy methodologies, their flaws, and present evidence supporting the use of 3DMB as an adjunct to diagnosis, prior to definitive treatment, to better stage disease and allow more informed decisions regarding treatment options. In addition, 3DMB allows for focal therapy, as individual lesions can be identified and subsequently targeted. Finally, we present a theoretical basis for 3DMB, and review clinical results in the literature. 3DMB allows physicians and patients to better match tumor burden with appropriate treatment selection, thereby minimizing treatment-related morbidity and potentially improving clinical outcomes.

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Abbreviations

3DMB:

Three-dimensional, template-guided, transperineal mapping/staging biopsy

AS:

Active surveillance

DRE:

Digital rectal examination

PCa:

Prostate cancer

PSA:

Prostate-specific antigen

RP:

Radical prostatectomy

RT:

Radiation therapy

TFT:

Targeted-focal therapy

TRUS:

Transrectal ultrasound

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Author information

Authors and Affiliations

  1. Division of Urology, University of Colorado, Anschutz Medical Campus, Mail Stop #F710, 6510, Aurora, CO, 80045, USA

    Samuel Clark Berngard M.D.

  2. University of Colorado, Anschutz Medical Campus, 12631 E. 17th Avenue, MS C-317, Aurora, CO, 80045, USA

    Kyle O. Rove M.D.

  3. SLK Kliniken Heilbronn, University of Heidelberg, Am Gesundbrunnen 20-24, Heilbronn, 74078, Germany

    Jens Rassweiler M.D.

  4. University of Applied Sciences Heilbronn, Medical Informatics, Max-Planck-Strasse 39, Heilbronn, Baden-Wuerttemberg, 74081, Germany

    Oliver Kalthoff

  5. Department of Urology, SLK-Kliniken GmbH, Am Gesundbrunnen 20-26, Heilbronn, 74078, Germany

    Marcel Hruz

  6. University of Colorado, Denver, Mail Stop #F 710, #6510, Aurora, CO, 80045, USA

    E. David Crawford M.D.

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  1. Samuel Clark Berngard M.D.
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  2. Kyle O. Rove M.D.
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  3. Jens Rassweiler M.D.
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  4. Oliver Kalthoff
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  5. Marcel Hruz
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  6. E. David Crawford M.D.
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Corresponding author

Correspondence to Kyle O. Rove M.D. .

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Editors and Affiliations

  1. , Department of Surgery, Duke Cancer Institute, Room 1089 Duke South, Durham, 27710, North Carolina, USA

    Thomas J. Polascik

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Berngard, S.C., Rove, K.O., Rassweiler, J., Kalthoff, O., Hruz, M., Crawford, E.D. (2013). 3D Image-Guided Mapping Biopsy for Defining Spatial Distribution of Prostate Cancer. In: Polascik, T. (eds) Imaging and Focal Therapy of Early Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-182-0_8

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  • DOI: https://doi.org/10.1007/978-1-62703-182-0_8

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