title: Management of an increasing prostate-specific antigen level after negative prostate biopsy.
abstract: Patients who have a previously negative biopsy in the setting of clinical suspicion of prostate cancer still have a high risk of harboring significant undiagnosed disease. Various markers such as prostate-specific antigen (PSA) velocity, PSA density, PCA3, and newer markers may aid in repeat biopsy selection. Repeating the same biopsy procedure in such patients does not yield high cancer detection rates. More anteriorly directed transrectal or transperineal biopsies are indicated. Multiparametric magnetic resonance imaging can detect abnormal areas, and lesion-targeted biopsies can improve the cancer detection rate.
authors.affiliation: Department of Urology, University of California, San Francisco, 1600 Divisadero Street A-634, San Francisco, CA 94143-1695, USA. Electronic address: kshinohara@urology.ucsf.edu.
authors.forename: Katsuto
authors.initials: K
authors.lastname: Shinohara
authors.affiliation: Department of Urology, University of California, San Francisco, 1600 Divisadero Street A-634, San Francisco, CA 94143-1695, USA.
authors.forename: Hao
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Department of Urology, University of California, San Francisco, 1600 Divisadero Street A-634, San Francisco, CA 94143-1695, USA.
authors.forename: Selma
authors.initials: S
authors.lastname: Masic
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D015203:Reproducibility of Results
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: Anterior cancer; Multiparametric magnetic resonance imaging; PCA3; Repeat prostate biopsy; Transperineal prostate biopsy; Transrectal ultrasonography