title: Does HistoScanning™ predict positive results in prostate biopsy? A retrospective analysis of 1,188 sextants of the prostate.
abstract: OBJECTIVE
  The role of HistoScanning™ (HS) in prostate biopsy is still indeterminate. Existing literature is sparse and controversial. To provide more evidence according to that important clinical topic, we analyzed institutional data from the Martini-Clinic, Prostate Cancer Center, Hamburg.
  
  
  METHODS
  Patients who received prostate biopsy and who also received HS were included in the study cohort. A single examiner, blinded to pathological results, re-analyzed all HS data in accordance with sextants of the prostate. Each sextant was considered as an individual case. Corresponding results from biopsy and HS were analyzed. The area under the receiver-operating characteristic curve (AUC) for the prediction of a positive biopsy by HS was calculated. Furthermore, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were assessed according to different HS signal volume cutoffs (>0, >0.2 and >0.5 ml).
  
  
  RESULTS
  Overall, 198 men were identified and 1,188 sextants were analyzed. The AUC to predict positive biopsy results by HS was 0.58. Sensitivity, specificity, PPV and NPV for HS to predict positive biopsy results per sextant, depending on different HS signal volume cutoffs (>0, >0.2 and >0.5 ml) were 84.1, 27.7, 29.5 and 82.9 %, 60.9, 50.6, 28.8 and 79.7 %, and 40.1, 73.3, 33.1 and 78.8 %, respectively.
  
  
  CONCLUSIONS
  Positive HS signals do not accurately predict positive prostate biopsy results according to sextant analysis. We cannot recommend a variation of well-established random biopsy patterns or reduction of biopsy cores in accordance with HS signals at the moment.
authors.affiliation: Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, schiffmann@martini-klinik.de.
authors.forename: J
authors.initials: J
authors.lastname: Schiffmann
authors.forename: P
authors.initials: P
authors.lastname: Tennstedt
authors.forename: J
authors.initials: J
authors.lastname: Fischer
authors.forename: Zhe
authors.initials: Z
authors.lastname: Tian
authors.forename: B
authors.initials: B
authors.lastname: Beyer
authors.forename: K
authors.initials: K
authors.lastname: Boehm
authors.forename: M
authors.initials: M
authors.lastname: Sun
authors.forename: G
authors.initials: G
authors.lastname: Gandaglia
authors.forename: U
authors.initials: U
authors.lastname: Michl
authors.forename: M
authors.initials: M
authors.lastname: Graefen
authors.forename: G
authors.initials: G
authors.lastname: Salomon
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*