Limited additional lateral biopsies improve the diagnostic accuracy of transrectal ultrasound guided sextant prostate biopsy

Abstract

We prospectively evaluated the need for routine use of additional lateral biopsies at the time of standard sextant prostatic biopsy to reduce the false negative rates. A total of 23 consecutive patients underwent 24 TRUS guided prostatic biopsies resulting in 246 biopsy cores. Prostate cancer was diagnosed in 8/24 (33.3%) biopsies. Although the age and prostate volume did not significantly differ between patients with or without cancer (p>O. 05), the pre-biopsy PSA and PSAD were significantly higher in pa-tients diagnosed with prostate cancer (p< 0.05). Of the 8 patients diagnosed with prostate cancer 2/8 (25%) had cancer in the biopsies lateral to but not in the standard sextant biopsy sites. The additional lateral biopsies im-proved the sensitivity and negative predictive value of TRUS guided biopsy by 33.3% and 13% respectively. In conclusion, in spite of the small sample size in this study, prostate cancer detection is increased by 25% because of additional lateral biopsies at time of standard sextant prostatic biopsy