@Article{,
AUTHOR = {Nikola C. Teslovich, Peter Elliott, Christopher S. Elliott},
TITLE = {Evaluating limited biopsy templates for men with markedly elevated PSAs},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {3},
PAGES = {11886--11891},
URL = {http://www.techscience.com/CJU/v31n3/59586},
ISSN = {1488-5581},
ABSTRACT = {Introduction: To define the smallest prostate needle
biopsy (PNB) template necessary for accurate tissue
diagnosis in men with markedly elevated PSA while
decreasing procedural morbidity.
Materials and methods: We performed a chart
review of 80 men presenting with a newly elevated PSA
> 100 ng/mL who underwent biopsy (PNB or metastatic site).
For patients who underwent a full 12-core biopsy, simulated
templates of 2- to 10-cores were generated by randomly
drawing subsets of biopsies from their full-template findings.
Templates were iterated to randomize core location and
generate theoretical smaller template outcomes. Simulated
biopsy results were compared to full-template findings
to determine accuracy to maximal Grade Group (GG)
diagnosis.
Results: Amongst those that underwent PNB, 93% had
GG 4 or 5 disease. Twenty-two (40%) underwent a full
12-core biopsy, 20 (37%) a 6-core biopsy, and only 8 (15%)
had fewer than six biopsy cores sampled at our hospital.
Simulated templates with 2-, 4-, 6-, and 8-cores correctly
diagnosed prostate cancer in all patients, and accurately
identified the maximal GG in 82%, 91%, 95%, and 97%
of patients, respectively. The biopsy locations most likely
to detect maximal GG were medial mid and base sites
bilaterally. A 4-core template of these sites would have
accurately detected the maximal GG in 95% of patients
relative to a full 12-core template.
Conclusions: In men presenting with PSA > 100 ng/
mL, decreasing from a 12-core to a 4-core prostate biopsy
template results in universal cancer detection and minimal
under-grading while theoretically decreasing procedural
morbidity and cost.},
DOI = {}
}