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TRUS Biopsy: Is There Still a Role?

  • Chapter
The Prostate Cancer Dilemma

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Abstract

Prostate biopsy remains the single most valuable pretreatment source of prognostic information, relating Gleason score, and volume estimates. Compared with sextant biopsy, extended sampling schema involving 12 cores incorporating the apical and lateral peripheral zone offers improved cancer detection rates. Well-reported limitations of systematic TRUS prostate biopsy include both over- and undersampling of disease that may be associated with disease mischaracterization, in addition to low but considerable rates of biopsy-related complications. The integration of additional ultrasonographic parameters including contrast enhancement, Power Doppler Imaging, and elastography has been explored to improve the discrimination of suspicious lesions during biopsy while means to refine initial selection for biopsy utilizing novel serum biomarkers appear to offer specificity beyond PSA and clinical parameters alone. In the setting of an initial negative biopsy, tissue-based methylation assays of histologically benign tissue may improve the negative predictive value of biopsies and reduce the need for repeat sampling. In addition, significant promise is held by the integration of magnetic resonance imaging modalities with TRUS-Bx to offer targeted biopsy strategies.

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  1. Department of Urology, University of California, San Francisco, UCSF Box 1695, 550 16th Street, 6th Floor, San Francisco, CA, 94143, USA

    Michael S. Leapman M.D. & Katsuto Shinohara M.D.

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  1. Michael S. Leapman M.D.
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  2. Katsuto Shinohara M.D.
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Correspondence to Katsuto Shinohara M.D. .

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  1. Department of Urology, The Icahn School of Medicine at Mount Sinai, Professor of Urology and Radiation Oncology, New York, New York, USA

    Nelson N. Stone

  2. Radiation Oncology, University of Colorado, Denver , Professor of Urology/Surgery, Aurora, Colorado, USA

    E. David Crawford

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Leapman, M.S., Shinohara, K. (2016). TRUS Biopsy: Is There Still a Role?. In: Stone, N., Crawford, E. (eds) The Prostate Cancer Dilemma. Springer, Cham. https://doi.org/10.1007/978-3-319-21485-6_4

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  • DOI: https://doi.org/10.1007/978-3-319-21485-6_4

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