No abstract available.
Biopsy* ; Prostate*

No abstract available.
Biopsy* ; Prostate*

No abstract available.
Biopsy* ; Prostate*

Transrectal ultrasonography (TRUS) in prostate cancer could show the images of multiform prostate adenomas. Specific sign is a hypoechoic area in periphery of gland. Overall, sensitivity (32%) and specificity (51%) of TRUS in diagnosis prostate cancer weren’t high. The false negative was from 30% to 40%. Two major roles of TRUS were to determine suspected lesions and to increase accuracy of prostate biopsy. TRUS techniques in diagnosis prostate cancer were: conventional TRUS, TRUS with Doppler, TRUS with contrast Doppler, and TRUS with 3D ultrasound. Under TRUS-guiding, biopsy can be performed through perineum or rectum
Prostate ; Biopsy ; Ultrasonography

Prostate specific antigen(PSA) is an extremely valuable tumor marker. However, its use in detection of prostate cancer is limited by low sensitivity and specificity. To enhance the accuracy of serum PSA we used the quotient of serum PSA and prostate volume, which is referred to as prostate specific antigen density(PSAD). Prostate volume in this study was calculated from transrectal ultrasonographic determinations using the formula, length x width x depth x 0.52 = volume. The serum PSA was analyzed using the Hybritech assay. Prostate biopsy was performed transperineally from at least six sites. The cancer detection rate was 3.3%(three out of 91 patients) in the group with PSA value of less than 4.0ng/ml and 11.3%(eight out of 71 patients) in the group with PSA value of 4.1 to 10. 0ng/ml. In the latter group, mean PSA value for the positive(n=8) and negative(n=63) biopsy group was 7.10+/-1.22 and 6.61+/-1.79ng/ml each(p=0.4630), but mean PSAD value was 0.275+/-0.089 and 0.187+/-0.078 each(p=0.0045). In the group of 38 patients with PSA value of 10.1 to 20.0ng/m1, the cancer detection rate was 15.8%(six patients) and the mean PSA value for the positive(n=6) and negative(n=32) biopsy group was 15.5+/-3.09 and 13.4+/-2.78ng/ml each(p=0. 1038), but the mean PSAD value was 0.535+/-0.082 and 0.334+/-0.182 each(p=0.0128). These results suggest that PSAD be useful in distinguishing BPH and prostate cancer in the patients with intermediate PSA values(4.1ng/ml to 20.0ng/ml).
Biopsy ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Sensitivity and Specificity

PURPOSE: To identify the prostate cancer detection rate on the patients who had second prostate biopsy out of the patients who were reported negative in their first biopsy. MATERIALS AND METHODS: From July 2006 to February 2012, prostate biopsy was performed on 843 patients with over 4 ng/ml and on 618 biopsy negative patients PSA was performed from between 6 months and 9 months after biopsy. On 164 patients, second biopsy was performed, and 42 patients were selected. If there was less than 10% change between PSA before the prostate biopsy and PSA measured during 6 to 9 months after the first biopsy it was considered as no change. If above 10% increase, it was considered increase and if above 10% decrease it was considered as decrease. RESULTS: The cancer detection rate in PSA increase group was 20%, the detection rate in no change in PSA level but still over the normal range group 8.3%, and that in the PSA decrease group was 0%. When comparing prostate cancer group and non-cancer group, it is more probable to have prostate cancer when they are older, prostate volume is smaller and PSA density is higher. CONCLUSIONS: The second biopsy is strongly recommended when PSA level shows no change or increase, age is older, prostate volume is smaller or PSA density is higher.
Biopsy ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Reference Values

PURPOSE: Atypical small acinar proliferation (ASAP) denotes the presence of suspicious glands with insufficient cytological architecture for a definitive prostate cancer diagnosis. We evaluated the subsequent prostate cancer detection rate of rebiopsy in patients with an initial diagnosis of ASAP. MATERIALS AND METHODS: Between January 2003 and December 2006, 1,416 men with suspected prostate cancer underwent a transrectal ultrasound-guided prostate biopsy, and 214 (15.1%) were diagnosed as having ASAP. Ninety-five of the 215 patients underwent at least one more biopsy. We evaluated the cancer detection rates after rebiopsy. RESULTS: In men with ASAP, 36 patients (37.9%) had prostate cancer. The cancer detection rates of the 1st, 2nd, and 3rd rebiopsies were 30.5%, 23.8%, and 40%, respectively. Mean patient age and prostate-specific antigen did not differ significantly between the prostate cancer and noncancer groups after rebiopsy. Prostate volume, however, was significantly smaller in the cancer group (p<0.05). CONCLUSIONS: Our results showed a detection rate for prostate cancer of 37.9% after an initial diagnosis of ASAP, which indicates that an initial diagnosis of ASAP mandates rebiopsy.
Biopsy ; Humans ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

Purpose: The purpose of our study was to evaluate the effectiveness of the 12 core biopsy protocol in detecting prostate cancer by comparison with that of the 6 core biopsy according to the prostate-specific antigen (PSA) level and prostate volume. Materials and Methods: Between January 2000 and April 2005, transrectal ultrasound-guided prostate biopsies were performed on 1,100 men suspected of prostate cancer. Biopsy cores were taken from 12 sites, consisting of the routine sextant cores and 6 additional cores from the far lateral areas (lateral apex, mid-lobe and base). The protocol with cores taken from all 12 sites was defined as the '12 core biopsy protocol' and the protocol with cores taken from the medial 6 sites only as the '6 core biopsy protocol'. The cancer detection rates of the two methods were analyzed according to the PSA level and prostate volume. Results: The cancer detection rates were 30.6 (337/1,100) and 25.7% (283/1,100) for the 12 and 6 core biopsy protocols, respectively. The patients were stratified into 3 groups according to their PSA level, and another 3 groups according to their prostate volume. The detection rates of the 12 core biopsy protocol were higher in all groups. The patients were stratified into a further 9 groups according to both their PSA level and prostate volume. The 12 core biopsy protocol proved to be more effective than the 6 core biopsy protocol in most groups, with the exception of groups with a relatively low PSA and large prostate volume and those with a relatively high PSA and small prostate volume. Furthermore, when stratified by the PSA density (PSAD), the 12 core biopsy protocol showed higher detection rates in patients with levels between 0.05 and 0.3. Conclusions: These results show that the detection rate of the 12 core biopsy protocol is higher in most groups, with the exception of groups with an extremely low or high PSAD, which suggests the PSAD may be a useful factor in determining the number of cores required for a prostate biopsy.
Biopsy* ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms

Purpose: We evaluated the improvement in the rate of prostate cancer detection with the use of an extensive 12-site biopsy protocol in patients with only an elevated level of serum prostate-specific antigen (PSA). Materials and Methods: A total of 109 men with elevated PSA levels between 3 and 20ng/ml, but with no abnormal finding on digital rectal and transrectal ultrasound examinations, received transrectal ultrasound- guided prostate biopsies, which were performed at 12 sites, including the routine sextant and 6 far lateral regions (lateral apex, mid-lobe and base). The improvement in the detection rate was assessed according to the PSA level and prostate volume. Results: The mean age and PSA level of the patients were 63.5 8.6 years and 7.0 3.7ng/ml, respectively. Twenty-eight (25.7%) out of 109 men were diagnosed with prostate cancer. A traditional sextant biopsy detected 19 (67.9%) of the 28 prostate cancer patients, while 9 (32.1%) cancers were detected in the lateral region only. Overall, this extensive protocol resulted in a significant improvement, 8.3% (17.4 to 25.7%), in the detection rate (p=0.032). The improvement in men with a PSA of 10 ng/ml or less was 8.1% (14.0% to 22.1%, p=0.007) and in those with a PSA greater than 10 ng/ml the improvement was 8.7% (30.4% to 39.1%, p=0.162). The improvement in men with a prostate volume of 50cc or less was 8.0% (22.3% to 30.3%, p=0.083) and in those with a prostate volume greater than 50cc this was 9.1% (6.1% to 15.2%, p=0.043). Conclusions: The twelve-site biopsy protocol is a more efficient method in men with a PSA and prostate volume of 10ng/ml or less and greater than 50cc, respectively, compared to the sextant protocol.
Biopsy* ; Humans ; Male ; Prostate ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: We retrospectively investigated the changes of prostate cancer detection rate according to patients prostate volume, age with prostate-specific antigen (PSA) levels of above 4.0ng/ml. MATERIAL AND METHODS: Data were collected from 663 patients who underwent 10 core prostate biopsy for elevated PSA above 4.0ng/ml. The biopsy-proven cancer patient group was compared to the non-cancer patient group according to age, PSA, prostate volume and PSAD. Prostate cancer detection rate was calculated according to prostate volume (less than 40 vs 40 or more 40ml) and age (less than 60, 60-69, 70-79, 80 or more years old). Also we compared prostate cancer detection rate according to PSA levels (4-10 vs 10-20ng/ml). RESULTS: Among the 663 patients who underwent prostate biopsy, prostate cancer was detected in 134 patients (20.2%). There were no stastically difference in mean age, mean prostate volume, and mean PSAD except mean PSA (13.9 vs 11.9ng/ml) between cancer and non-cancer groups. The cancer detection rate in small prostate was significantly higher than large prostate (23.5% vs 16.0%). The cancer detection rate was significantly increased with age: from 14.5% for below 60 year-old patients to 30.3% for the 80 or more year-old patients. There was no significant difference in cancer detection rate between the two PSA groups (19.0 vs 20.5%). CONCLUSION: Prostate cancer detection rate was higher in old patients and patients with small prostate volume. The older age group and the patients with small prostate volume was considered as the important factors to decide whether biopsy of prostate is needed.
Biopsy ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Retrospective Studies