title: Incremental detection rate of prostate cancer by real-time elastography targeted biopsies in combination with a conventional 10-core biopsy in 1024 consecutive patients.
abstract: OBJECTIVE
  To quantify the incremental detection rate (DR) of a targeted biopsy in addition to a randomized 10-core biopsy.
  
  
  METHODS
  This retrospective study analysed 1024 patients who consecutively underwent a four-core real-time elastography (RTE) targeted biopsies in addition to a randomized 10-core transrectal ultrasonography (TRUS)-guided biopsy in a primary or rebiopsy setting. The overall DR, the DR of a 10-core randomized, RTE targeted biopsy and the incremental DR were calculated.
  
  
  RESULTS
  Overall, randomized and RTE targeted biopsy DRs (for the combination, the 10-core and the four-core RTE biopsy scheme) were 46.2% (n = 473), 39.1% (n = 400) and 29.0% (n = 297), respectively. Four-core RTE targeted biopsies detected an additional 73 patients not detected by the 10-core randomized biopsies (increase in the overall DR of 7.1%). This represented a relative increase in DR of 18.3%. The incremental DR was better in rebiopsy patients (24.8%) than in patients having their first biopsy (14.7%). Within all patients diagnosed by RTE targeted biopsy only, 34 patients harboured significant Gleason 4 or 5 prostate cancer (PCa), diagnosed by four-core RTE biopsy only. Moreover, PCa with a Gleason grade of 4 or 5 was detected by four-core RTE biopsies in 30 patients, who showed low-grade PCa ≤ Gleason 3 only in the systematic 10-core biopsy.
  
  
  CONCLUSIONS
  Real-time elastography targeted biopsy seems to be an appropriate method for increasing the DR of PCa. Nevertheless, RTE targeted biopsies missed a high proportion of patients with PCa and should therefore be considered as an addition to randomized biopsies.
authors.affiliation: Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Salomon
authors.forename: Nils
authors.initials: N
authors.lastname: Drews
authors.forename: Philippe
authors.initials: P
authors.lastname: Autier
authors.forename: Ann
authors.initials: A
authors.lastname: Beckmann
authors.forename: Hans
authors.initials: H
authors.lastname: Heinzer
authors.forename: Jens
authors.initials: J
authors.lastname: Hansen
authors.forename: Uwe
authors.initials: U
authors.lastname: Michl
authors.forename: Thorsten
authors.initials: T
authors.lastname: Schlomm
authors.forename: Alex
authors.initials: A
authors.lastname: Haese
authors.forename: Thomas
authors.initials: T
authors.lastname: Steuber
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
mesh_terms: D062005:Biopsy, Large-Core Needle / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D011897:Random Allocation; D019233:Retreatment; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen
keywords: detection rate; elastography; prostate biopsy; prostate cancer