title: Negative predictive value of systematic ultrasound-guided prostate biopsy: which tumours do we miss?
abstract: BACKGROUND
  The aim of the study was the determination of the negative predictive value of sextant core prostate biopsy.
  
  
  METHODS
  Prostate cancer was diagnosed in 126 patients by systematic ultrasound-guided sextant biopsy and was subsequently treated with radical prostatectomy. The prostatectomy specimens were examined histopathologically using the whole-mount section technique.
  
  
  RESULTS
  81 patients were diagnosed with unilateral and 45 with bilateral prostate cancer after biopsy. In 15/81 patients, the diagnosis of unilateral disease was confirmed by the whole-mount sections; 66 patients turned out to have bilateral disease. In 14/66 cases, the missed tumour foci were diminutive. In the remaining 52 patients, an erroneous diagnosis of unilateral prostate cancer had been made after biopsy, although the missed tumour foci were not diminutive. The negative predictive value of sextant core biopsy with respect to unilateral disease was 36%.
  
  
  CONCLUSIONS
  An unexpectedly high number of tumour foci are missed by systematic ultrasound-guided sextant prostate biopsy.
authors.affiliation: Prostate Center, Department of Urology, University Clinic Münster, Münster, Germany. kopket@ukmuenster.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Köpke
authors.forename: Frank
authors.initials: F
authors.lastname: Oberpenning
authors.forename: Olaf
authors.initials: O
authors.lastname: Bettendorf
authors.forename: Elke
authors.initials: E
authors.lastname: Eltze
authors.forename: Edwin
authors.initials: E
authors.lastname: Herrmann
authors.forename: Lothar
authors.initials: L
authors.lastname: Hertle
authors.forename: Christoph
authors.initials: C
authors.lastname: Weining
authors.forename: Christian
authors.initials: C
authors.lastname: Wulfing
authors.forename: Axel
authors.initials: A
authors.lastname: Semjonow
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
chemical_list: D017430:Prostate-Specific Antigen