In fact, the total number of biopsy cores was A small prostate is also an important and noteworthy sign of prostate cancer detection. Jiang et al. Miyoshi et al. Our present results also confirmed that VBR cut-off value 3. We should interpret the meaning of VBR carefully. The fact that the cancer detection rate is higher in patients with a smaller VBR means that the number of biopsy cores is adequate and that patients with a smaller PV are more likely to have prostate cancer.
This result is also confirmed by the fact that patients with a higher PSAD show a higher cancer detection rate. The conceivable reason for these results is that the cancer volume of younger patients is probably smaller than that of older patients. Comparison of cancer detection rates in previous reports of studies in large numbers of patients. The present study showed an acceptable result of adverse events after biopsy Table 7.
The cancer detection rate in our study is also equivalent to that in previous studies with a greater number of biopsy cores Table 8. Our present study revealed that the cancer detection rate using the NURTG nomogram allocating a number of 6—12 biopsy cores, the number generally used in daily practice, based on age and PV could lead to similar efficacy compared with previous studies with a more expanded number of biopsy cores.
In older patients the number of biopsy cores can be reduced. NT performed the statistical analysis. All authors read and approved the final manuscript. We thank Ms. Mariko Yoshimura who managed the data base of this study. Keiji Shimada, Email: pj. Yoshinori Nakagawa, Email: pj. Shuya Hirao, Email: pj. Shuji Watanabe, Email: pj. Makito Miyake, Email: pj.
Satoshi Anai, Email: pj. Akihide Hirayama, Email: pj. Noboru Konishi, Email: pj. Kiyohide Fujimoto, Email: pj. National Center for Biotechnology Information , U.
BMC Res Notes. Published online Nov Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Dec 5; Accepted Nov 2. This article has been cited by other articles in PMC. Abstract Background To elucidate the optimal number of prostate biopsy cores using a nomogram allocating 6—12 biopsy cores, the number generally used in daily practice, based on age and prostate volume PV.
Methods We enrolled patients who received an initial prostate biopsy from April to January Results The total cancer detection rate and the cancer detection rate in the PSA gray zone 4. Conclusions Our present study revealed that the cancer detection rate using the NURTG nomogram allocating 6—12 biopsy cores, the number generally used in daily practice, based on age and PV, could provide similar efficacy as previous studies involving more biopsy cores.
Background Since the concept of systematic prostate biopsy has been introduced, the number of biopsy cores has increased to 12 cores.
Open in a separate window. Results The patient characteristics are shown in Table 2. Table 3 Cancer detection rates according to PSA stratification. Table 4 Cancer detection rates stratified by age and prostate volume in all patients. Table 5 Cancer detection rate stratified by age and prostate volume in gray zone patients.
Table 6 Logistic regression analysis predicting positive biopsy in the gray zone. Grade 2 Grade 3 Hematuria 0. Discussion In our previous retrospective studies on prostate biopsy [ 6 , 7 ], we used 6—8 biopsy cores, and the cancer detection rate in all patients and patients with gray zone PSA was relatively low.
Table 8 Comparison of cancer detection rates in previous reports of studies in large numbers of patients. Conclusion Our present study revealed that the cancer detection rate using the NURTG nomogram allocating a number of 6—12 biopsy cores, the number generally used in daily practice, based on age and PV could lead to similar efficacy compared with previous studies with a more expanded number of biopsy cores.
Acknowledgements We thank Ms. Competing interests The authors declare that they have no competing interests. Another uncommon but dangerous complication is urinary retention—the inability to pass urine caused by an infection. Seek care immediately if you stop being able to urinate after a biopsy. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
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Free Healthbeat Signup Get the latest in health news delivered to your inbox! With continuous ultrasound imaging, the doctor can view the biopsy needle as it advances to the prostate in real time. The doctor will repeat the biopsy sampling to ensure coverage of the visible abnormal area. Many times, the doctor will take tissue samples from normal-appearing areas to ensure no cancer is hiding there.
Usually, the doctor will take between six and 14 individual samples during the ultrasound-guided procedure. These samples are sent to a pathologist for lab analysis. After taking the tissue samples, the doctor removes the probe. If you had a general anesthetic, they will wake you. The doctor will give you a small pad to wear in case of any bleeding. You will be kept under observation until they are satisfied with your condition.
As with the ultrasound procedure, you may receive antibiotics, sedatives, and pain medication before the biopsy. The MRI-guided procedure may use contrast material. A nurse or technologist will insert an intravenous IV catheter into a vein in your hand or arm. The doctor gently inserts the biopsy guide into the rectum. Using imaging guidance, the doctor guides the biopsy needle into position and takes a tissue sample.
The doctor will place a guidance grid between your legs. Using imaging guidance, the doctor will advance the biopsy needle through the grid into the targeted prostate tissue. MRI-guided biopsies may require two to 14 biopsy samples.
The number of samples will depend on whether the doctor is focusing on one area or performing a mapping biopsy. MRI-guided prostate biopsy takes 30 to 90 minutes, with post-procedure monitoring for 45 to 60 minutes. For this procedure, the MR images are fused to real-time ultrasound US imaging to help target biopsy sites. If you receive IV contrast for the MRI-guided procedure, you may feel coolness and a flushing sensation for a minute or two following the injection.
The IV needle may cause some discomfort when the doctor inserts it and you may have some bruising when they remove it. Rarely, patients may experience side effects from MR contrast material, such as nausea and local pain, hives, itchy eyes, or other reactions.
If you have allergic symptoms, a radiologist or other doctor will be available for immediate assistance. When the doctor inserts the ultrasound probe or endorectal coil into the rectum, you will feel pressure and may have some temporary discomfort.
You will hear a clicking noise when the biopsy needle samples the prostate and you may feel a stinging or burning sensation in the area. Some patients find it uncomfortable to remain still during an MRI. Others experience a sense of being closed-in claustrophobia. Sedation is available for patients who anticipate anxiety. If you feel heating on your skin at any time during MR imaging, tell the MR technician so they can closely examine the area.
Some patients experience a small amount of bleeding from the rectum or perineum immediately after the biopsy. If this does occur, it will cease with gentle pressure.
If you did not receive sedation, no recovery period is necessary. Light general anesthetic or sedation may leave you feeling groggy for a day or so. You may feel pain and discomfort in the area for a day or two, particularly when you are sitting down. A pathologist examines the tissue samples and makes a final diagnosis.
Biopsy results usually are available to your doctor a few days after the procedure. The time it takes may vary based on the complexity of the exam, specimen prep time, need for a second opinion, and other factors.
A biopsy can only show if there is cancer in the tissue samples. It is possible to miss cancer in unsampled areas of the prostate. For MRI-guided biopsies, you must remain perfectly still to ensure the technologist captures high-quality images. If you are anxious, confused, or in severe pain, it may be hard to lie still.
If so, the images may not be of high enough quality to be useful. Likewise, the presence of an implant or other metallic object sometimes makes it difficult to obtain clear MR images. A person who is very large may not fit inside certain types of MRI machines. Bleeding may sometimes occur in the prostate after a biopsy. MR imaging cannot always tell the difference between cancer, inflammation, or the presence of blood. To avoid confusing them, your doctor may perform a repeat MRI six to eight weeks after the biopsy to allow residual bleeding to resolve.
An MRI exam typically costs more and may take more time than other imaging exams. Talk to your insurance provider if you have concerns about the cost of MRI. Please type your comment or suggestion into the text box below.
Note: we are unable to answer specific questions or offer individual medical advice or opinions. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician.
To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America RSNA and the American College of Radiology ACR , comprising physicians with expertise in several radiologic areas.
Outside links: For the convenience of our users, RadiologyInfo. Toggle navigation. What are some common uses of the procedure? How should I prepare? What does the equipment look like? How does the procedure work? How is the biopsy procedure performed? What will I experience during and after the biopsy? Who interprets the results and how do I get them? What are the benefits vs.
Which test, procedure or treatment is best for me? Ultrasound equipment: Ultrasound scanners consist of an electronic console containing a computer, video monitor, and a handheld transducer probe. Ultrasound procedure: Ultrasound imaging uses the same principles as the sonar that bats, ships, and fishermen use. Ultrasound-guided biopsy procedure: A radiologist or urologist will perform an ultrasound-guided prostate biopsy.
You will lie on your left side with your legs bent for the procedure. The doctor will first carry out a digital rectal exam DRE with a gloved finger. The entire ultrasound-guided biopsy procedure usually takes 45 minutes or less. Benefits Ultrasound- and MRI-guided prostate biopsies help accurately diagnose abnormalities in the prostate and speed the start of appropriate treatment. Biopsies help distinguish between cancer and BPH. Ultrasound is widely available, easy-to-use, and less expensive than other imaging methods.
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