title: The Efficacy of Target Biopsy of Suspected Cancer Lesions Detected by Magnetic Resonance Imaging and/or Transrectal Ultrasonography during Initial Prostate Biopsies: Comparison of Outcomes between Two Physicians.
abstract: BACKGROUND
  The efficacy of adding target prostate biopsy (PBx) of suspected cancer lesions identified on magnetic resonance imaging (MRI) and/or transrectal ultrasonography (TRUS) to initial systematic PBx was evaluated. Moreover, the outcomes were compared between 2 physicians.
  
  
  METHODS
  We retrospectively investigated 238 patients who underwent first-time PBx in our hospital. All patients were examined with prostate MRI before PBx. Fourteen systematic biopsies were obtained in all patients. When a suspected lesion was present on MRI and/or TRUS, the lesion was the target of target PBx.
  
  
  RESULTS
  The overall detection rate of prostate cancer (PCa) was 45% (106/238). With target PBx, the PCa detection rate was 32% overall, while that of suspected lesions seen only on MRI was 32%, that of suspected lesions seen only on TRUS was 8% and that of suspected lesions seen on both MRI and TRUS was 52%. The same tendency was shown for each physician. Comparing systematic PBx and target PBx, the overall rate of Gleason score (GS) upgrading with target PBx was 13%. The rate of PCa detected only by systematic PBx was 95%. There was no significant difference between the 2 physicians.
  
  
  CONCLUSIONS
  In initial PBx, the addition of target PBx of suspected cancer lesions detected by MRI and/or TRUS to systematic PBx might not be useful to improve the cancer detection rate. However, it may enable more accurate risk classification and detection of minute cancers with a high GS.
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Hideto
authors: H
authors: Iwamoto
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Tetsuya
authors: T
authors: Yumioka
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Noriya
authors: N
authors: Yamaguchi
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Seiya
authors: S
authors: Inoue
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Toshihiko
authors: T
authors: Masago
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Shuichi
authors: S
authors: Morizane
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Akihisa
authors: A
authors: Yao
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Masashi
authors: M
authors: Honda
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Takehiro
authors: T
authors: Sejima
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan.
authors: Atsushi
authors: A
authors: Takenaka
keywords: magnetic resonance image; prostate cancer; target prostate biopsy; transrectal ultrasonography