title: Fragmentation of transrectal ultrasound-guided biopsy cores is influenced by the method of specimen retrieval.
abstract: OBJECTIVE
  To determine whether the method of specimen preparation after transrectal ultrasound-guided biopsy of the prostate affected core fragmentation, and secondly to determine whether such fragmentation was influenced by the presence of malignancy in the biopsy specimen.
  
  
  METHODS
  A prospective randomized study comparing 2 different mechanisms of specimen preparation, wash vs swipe of biopsy cores, with blinded assessment by a specific uropathologist was undertaken.
  
  
  RESULTS
  For those cores in which prostate cancer was present, the wash method of specimen preparation resulted in fewer and longer core fragments (P = .005). Those patients in whom cancer was present on biopsy also had a greater degree of biopsy core fragmentation in those cores in which only benign tissue was identified (P = .017). Gleason score did not appear to influence the extent of fragmentation.
  
  
  CONCLUSIONS
  The method of specimen preparation at prostate biopsy influences the degree of fragmentation seen at histologic evaluation. This has the potential to affect the interpretation of biopsy results, including suitability of patients for inclusion in active surveillance protocols. Core fragmentation might be minimized by modification of technique.
authors.affiliation: Department of Surgery and Department of Urology, University of Melbourne, Austin Health, Melbourne, Australia.
authors.forename: Prassannah
authors.initials: P
authors.lastname: Satasivam
authors.affiliation: Department of Surgery and Department of Urology, University of Melbourne, Austin Health, Melbourne, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Department of Surgery and Department of Urology, University of Melbourne, Austin Health, Melbourne, Australia.
authors.forename: Kenny
authors.initials: K
authors.lastname: Rao
authors.affiliation: Department of Surgery and Department of Urology, University of Melbourne, Austin Health, Melbourne, Australia.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Jack
authors.affiliation: Department of Surgery and Department of Urology, University of Melbourne, Austin Health, Melbourne, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
authors.affiliation: Department of Surgery and Department of Urology, University of Melbourne, Austin Health, Melbourne, Australia. Electronic address: damienmb@unimelb.edu.au.
authors.forename: Damien M
authors.initials: DM
authors.lastname: Bolton
mesh_terms: D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D016037:Single-Blind Method