Skip to main content
SpringerLink
Log in

Transrectal ultrasound-guided biopsy of the prostate gland: value of 12 versus 6 cores

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

We investigated the effect on prostate carcinoma detection of 12 versus 6 core biopsies at transrectal ultrasound (TRUS), when all biopsies are taken from the lateral peripheral zone. This was a prospective study of 202 consecutive men, ages 51 to 81 years, referred for TRUS-guided biopsy of the prostate gland. All patients had prostate serum antigen levels higher than 4.0 ng/mL and/or abnormal digital rectal examination. In each case three biopsies were taken from the peripheral zones of the right and left lobes of the prostate. Biopsies were taken at the apex, midway between the apex and the base, and at the base. A second set of biopsies was taken from the same regions and analyzed separately. In total, twelve biopsies were taken. Note was subsequently made of additional carcinoma diagnosis increase in Gleason grade, and new diagnoses of carcinoma in the opposite side of the gland diagnosed on the second set of biopsies alone. Seventy-eight of the 202 men (38.6%) had prostatic carcinoma diagnosed on TRUS-guided biopsy. Of these 78 patients, six were diagnosed with malignancy based on the second set of biopsies alone, a 2.9% increase in the 202 patients, representing an increased yield of 8.3% (95% confidence interval, 5.3–28.6%). In nine cases (12.5%; 95% confidence interval, 6.2–22.9%), the Gleason tumor grade was increased on the second set of sextant biopsies; in an additional nine cases, carcinoma was detected in the opposite side of the gland. There were two complications (1%). A 12- versus six-core biopsy strategy for TRUS-guided biopsy of the prostate gland improves detection and histologic grading of prostate carcinoma. The added benefit of additional biopsies was lower in this series than in some prior studies using extensive biopsy protocols.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. JR Thornbury DK Ornstein PL Choyke et al. (2001) ArticleTitle Prostate cancer. What is the future role of imaging? AJR 176 17–22 Occurrence Handle1:STN:280:DC%2BD3M3itlWjsA%3D%3D Occurrence Handle11133530

    CAS  PubMed  Google Scholar 

  2. E Kuligowska MA Barish HM Fenlon M Blake (2001) ArticleTitlePredictors of prostate carcinoma: Accuracy of gray-scale and color Doppler us and serum markers. Radiology 220 757–764 Occurrence Handle1:STN:280:DC%2BD3Mvotlagug%3D%3D Occurrence Handle11526279

    CAS  PubMed  Google Scholar 

  3. CH Dyke A Toi JM Sweet (1990) ArticleTitleValue of random US-guided transrectal prostate biopsy. Radiology 176 345–349 Occurrence Handle1:STN:280:By%2BA3M7msVY%3D Occurrence Handle2195588

    CAS  PubMed  Google Scholar 

  4. KK Hodge JE McNeal MK Terris TA Stamey (1989) ArticleTitleRandom systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol 142 71–75 Occurrence Handle1:STN:280:BiaB1c%2FgslY%3D Occurrence Handle2659827

    CAS  PubMed  Google Scholar 

  5. Hodge KK, McNeal JE, Stamey. Ultrasound guided transrectal core biopsies of the palpably abnormal prostate. J Urol 1989;142:66–70

  6. PG Borboroglu SW Comer RH Riffenburgh et al. (2000) ArticleTitleExtensive repeat transrectal ultrasound guided prostate biopsy in patients with previous benign sextant biopsies. J Urol 163 158–162 Occurrence Handle10.1097/00005392-200001000-00037 Occurrence Handle1:STN:280:DC%2BD3c%2Fmslyhtw%3D%3D Occurrence Handle10604336

    Article  CAS  PubMed  Google Scholar 

  7. GJ Dowd MC Miller R Orozco RW Veltri (2000) ArticleTitleAnalysis of repeated biopsy results within 1 year after a non-cancer diagnosis. Urology 55 553–559 Occurrence Handle10.1016/S0090-4295(00)00447-7 Occurrence Handle10736500

    Article  PubMed  Google Scholar 

  8. MK Terris EM Wallen TA Stamey (1997) ArticleTitleComparison of mid-lobe versus lateral systematic sextant biopsies in detection of prostate cancer. Urol Int 59 239–242 Occurrence Handle1:STN:280:DyaK1c7gslWntQ%3D%3D Occurrence Handle9444742

    CAS  PubMed  Google Scholar 

  9. LA Eskew RL Bare DL McCullough (1997) ArticleTitleSystematic 5 region biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J Urol 157 199–203 Occurrence Handle10.1097/00005392-199701000-00059 Occurrence Handle1:STN:280:ByiC3s%2FkvVM%3D Occurrence Handle8976250

    Article  CAS  PubMed  Google Scholar 

  10. MA Levine M Ittman J Melamed H Lepor (1998) ArticleTitleTwo consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. J Urol 159 471–476 Occurrence Handle1:STN:280:DyaK1czhtFGquw%3D%3D Occurrence Handle9649265

    CAS  PubMed  Google Scholar 

  11. V Ravery L Goldblatt B Royer et al. (2000) ArticleTitleExtensive biopsy protocol improves the detection rate of prostate cancer. J Urol 164 393–396 Occurrence Handle10.1097/00005392-200008000-00029 Occurrence Handle1:STN:280:DC%2BD3cvivF2rsw%3D%3D Occurrence Handle10893593

    Article  CAS  PubMed  Google Scholar 

  12. F Lee PJ Littrup L Loft-Christensen et al. (1992) ArticleTitlePredicted prostate specific antigen results using transrectal ultrasound gland volume: differentiation of benign prostatic hyperplasia and prostate cancer. Cancer 70 211–220 Occurrence Handle1:STN:280:By2B1cfot1E%3D Occurrence Handle1376190

    CAS  PubMed  Google Scholar 

  13. DP Byar FK Mostofi (1972) ArticleTitleCarcinoma of the prostate : prognostic evaluation of certain pathological features in 208 radical prostatectomies. Cancer 30 5–13 Occurrence Handle1:STN:280:CS2B38jgs1Q%3D Occurrence Handle5064808

    CAS  PubMed  Google Scholar 

  14. TA Stamey (1995) ArticleTitleMaking the most of six systematic sextant biopsies Urology 45 2–12 Occurrence Handle10.1016/0090-4295(95)80001-8 Occurrence Handle1:STN:280:ByqC3Mjit1U%3D Occurrence Handle7817477

    Article  CAS  PubMed  Google Scholar 

  15. JI Epstein PC Walsh HB Carter (2001) ArticleTitleImportance of posterolateral needle biopsies in the detection of prostate cancer Urology 57 1112–1116 Occurrence Handle10.1016/S0090-4295(01)00979-7 Occurrence Handle1:STN:280:DC%2BD387hslOltw%3D%3D Occurrence Handle11377320

    Article  CAS  PubMed  Google Scholar 

  16. CK Naughton DC Miller DE Mager et al. (2000) ArticleTitleA prospective randomized trial comparing 6 versus 12 prostate biopsy cores: impact on cancer detection J Urol 164 388–392 Occurrence Handle10.1097/00005392-200008000-00028 Occurrence Handle1:STN:280:DC%2BD3cvivF2rsg%3D%3D Occurrence Handle10893592

    Article  CAS  PubMed  Google Scholar 

  17. PH Arger SB Malkowicz KN Van Arsdalen et al. (2002) ArticleTitleImpact of the added biopsy areas on prostate cancer detection. J Ultrasound Med 21 135–139 Occurrence Handle11833869

    PubMed  Google Scholar 

  18. ME Chen P Troncoso D Johnston K Tang RJ Babaian (1999) ArticleTitleProstate cancer detection: relationship to prostate size. Urology 53 764–768 Occurrence Handle10.1016/S0090-4295(98)00574-3 Occurrence Handle1:STN:280:DyaK1M3htFOisg%3D%3D Occurrence Handle10197853

    Article  CAS  PubMed  Google Scholar 

  19. DF Gleason GT Mellinger (1974) ArticleTitlePrediction of prognosis for prostatic adenocarcinoma by combined histologic grading and clinical stage. J Urol 111 58–64 Occurrence Handle1:STN:280:CSuC3c3ks1w%3D Occurrence Handle4813554

    CAS  PubMed  Google Scholar 

  20. WJ Catalona DS Smith (1994) ArticleTitleFive year tumor recurrence rates after anatomical radical retropubic prostatectomy for prostate cancer. J Urol 152 1837–1842 Occurrence Handle1:STN:280:ByqD3MfotVY%3D Occurrence Handle7523731

    CAS  PubMed  Google Scholar 

  21. GS Gerber RA Thisted PT Scardino et al. (1996) ArticleTitleResults of radical prostatectomy in men with clinically localized prostate cancer. JAMA 276 615–619 Occurrence Handle10.1001/jama.276.8.615 Occurrence Handle1:STN:280:BymA28bmvFc%3D Occurrence Handle8773633

    Article  CAS  PubMed  Google Scholar 

  22. LV Rodriguez MK Terris (1998) ArticleTitleRisks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 160 2115–212 Occurrence Handle10.1097/00005392-199812010-00045 Occurrence Handle1:STN:280:DyaK1M%2Fjt1antQ%3D%3D Occurrence Handle9817335

    Article  CAS  PubMed  Google Scholar 

  23. CK Naughton DK Ornstein DS Smith WJ Catalona (2000) ArticleTitlePain and morbidity of transrectal ultrasound guided prostate biopsy: a prospective randomised trial of 6 versus 12 cores. J Urol 163 168–171 Occurrence Handle10.1097/00005392-200001000-00039 Occurrence Handle1:STN:280:DC%2BD3c%2FmslyhtQ%3D%3D Occurrence Handle10604338

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge grant assistance from the Faculty of Radiologists, of the Royal College of Surgeons, in Ireland.

Author information

Authors and Affiliations

  1. Department of Radiology, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland

    M. J. O’Connell, C. S. Smith, M. Behan, H. F. Fenlon & J. G. Murray

  2. Department of Public Health Medicine and Epidemiology, University College Dublin, Earlsfort Terrace, Dublin 2, Ireland

    P. E. Fitzpatrick

  3. Department of Pathology, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland

    C. O. Keane

  4. Department of Surgery, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland

    J. M. Fitzpatrick

Authors
  1. M. J. O’Connell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. S. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. E. Fitzpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. O. Keane
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. M. Fitzpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Behan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H. F. Fenlon
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. G. Murray
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. J. O’Connell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

O’Connell, M., Smith, C., Fitzpatrick, P. et al. Transrectal ultrasound-guided biopsy of the prostate gland: value of 12 versus 6 cores. Abdom Imaging 29, 132–136 (2004). https://doi.org/10.1007/s00261-003-0089-8

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-003-0089-8

Keywords

Search

Navigation