title: Transperineal ultrasound-guided 12-core systematic biopsy of the prostate for patients with a prostate-specific antigen level of 2.5-20 ng/ml in Japan.
abstract: BACKGROUND
  The aim of this study was to investigate the cancer detection rate in patients with a prostate-specific antigen (PSA) level of 2.5 to 20 ng/ml, using transperineal ultrasound-guided systematic biopsy of the prostate.
  
  
  METHODS
  Three hundred consecutive patients with PSA levels of 2.5 to 20 ng/ml underwent transperineal ultrasound-guided 12-core systematic biopsy of the prostate.
  
  
  RESULTS
  Prostate cancer was detected in 108 of the 300 patients (36.0%). The cancer detection rates in patients with total PSA levels of 2.5-4.0, 4.01-10.0 and 10.01-20.0 ng/ml were 18.2%, 31.0%, and 50.0%, respectively. The cancer detection rates in patients with prostate volumes of less than 30 cc and over 50 cc were almost 50%, and 13.3%, respectively. The cancer detection rate in patients with a PSA density (PSAD) of less than 0.10 ng/ml per cc was only 5.6%, and no prostate cancer was detected in patients with a free-to-total PSA ratio (% f PSA) over 40%.
  
  
  CONCLUSIONS
  We demonstrated a high prostate cancer detection rate by the transperineal ultrasound-guided 12-core systematic biopsy method in patients with PSA levels of 2.5 to 20 ng/ml. Accordingly, if the number of core biopsies is further increased overall, except in patients with a large prostate volume, and if the indication for biopsy is decided based on the PSAD and %f PSA, then the cancer detection rate by the present method may be further improved, with fewer unnecessary biopsies.
authors.affiliation: Department of Urology, Cancer Institute Hospital, 3-10-6 Ariake, Tokyo 135-8550, Japan. shinya.yamamoto@jfcr.or.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Ujin
authors.initials: U
authors.lastname: Kin
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hamano
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Nishikawa
authors.forename: Toshinao
authors.initials: T
authors.lastname: Takenouchi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Maruoka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
chemical_list: D017430:Prostate-Specific Antigen