Three-dimensional prostate mapping biopsy has a potentially significant impact on prostate cancer management.
OBJECTIVE
To compare a new staging, three-dimensional prostate mapping biopsy (3D-PMB) method with traditional transrectal ultrasound (TRUS) biopsy and assess its possible impact on patient management.


METHODS
One hundred eighty patients with unilateral cancer on TRUS biopsy, who were considering conservative management, underwent restaging with 3D-PMB. The 3D-PMB was carried out transperineally using a brachytherapy grid under TRUS guidance. Biopsies were taken every 5 mm throughout the volume of the prostate, and labeling of the specimen coordinates allowed accurate reconstruction of the location and extent of a patient's cancer.


RESULTS
3D-PMB obtained a median of 50 cores (standard deviation, +/- 20.61). One hundred ten patients (61.1%) were positive bilaterally, and 41 patients (22.7%) had Gleason scores increased to 7 or higher. Thirty-six patients had negative results on 3D-PMB. Complications of 3D-PMB were self-limited and included 14 patients (7.7%) who required short-term indwelling catheter drainage and two patients with hematuria, one of whom required overnight bladder irrigation.


CONCLUSIONS
3D-PMB is a transperineal biopsy that can be safely used to accurately stage prostate cancer patients. At the present time, when patient management is increasingly based on the extent and characteristics of prostate cancer, 3D-PMB could have a profound effect on patient management.
Onik
Gary
G
Department of Radiology, Florida Hospital Celebration Health, 400 Celebration Pl, Celebration, FL 34747, USA. onikcryo@aol.com
Miessau
Matthew
M
Bostwick
David G
DG
D001706:Biopsy / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000628:therapy; D015203:Reproducibility of Results