title: What is the ideal core number for ultrasound-guided prostate biopsy?
abstract: OBJECTIVE
  We evaluated the utility of 10-, 12-, and 16-core prostate biopsies for detecting prostate cancer (PCa) and correlated the results with prostate-specific antigen (PSA) levels, prostate volumes, Gleason scores, and detection rates of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP).
  
  
  METHODS
  A prospective controlled study was conducted in 354 consecutive patients with various indications for prostate biopsy. Sixteen-core biopsy specimens were obtained from 351 patients. The first 10-core biopsy specimens were obtained bilaterally from the base, middle third, apex, medial, and latero-lateral regions. Afterward, six additional punctures were performed bilaterally in the areas more lateral to the base, middle third, and apex regions, yielding a total of 16-core biopsy specimens. The detection rate of carcinoma in the initial 10-core specimens was compared with that in the 12- and 16-core specimens.
  
  
  RESULTS
  No significant differences in the cancer detection rate were found between the three biopsy protocols. PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798). The 10-, 12-, and 16-core protocols were compared with stratified PSA levels, stratified prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP; no significant differences were found.
  
  
  CONCLUSIONS
  Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy.
authors.affiliation: Graduate in Base of Surgery Program, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.
authors.forename: Renato Caretta
authors.initials: RC
authors.lastname: Chambó
authors.affiliation: Graduate in Base of Surgery Program, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.
authors.forename: Fábio Hissachi
authors.initials: FH
authors.lastname: Tsuji
authors.affiliation: Department of Pathology, Hospital das Clinicas, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: de Oliveira Lima
authors.affiliation: Department of Urology, Hospital das Clinicas, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.
authors.forename: Hamilto Akihissa
authors.initials: HA
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Hospital das Clinicas, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.
authors.forename: Carlos Márcio
authors.initials: CM
authors.lastname: Nóbrega de Jesus
mesh_terms: D000328:Adult; D000368:Aged; D049109:Cell Proliferation; D019160:Endosonography / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011446:Prospective Studies; D011467:Prostate / Q000378:metabolism / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000378:metabolism; D019048:Prostatic Intraepithelial Neoplasia / Q000378:metabolism / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D012007:Rectum; D015203:Reproducibility of Results
chemical_list: D017430:Prostate-Specific Antigen
keywords: Needle biopsy; Prostate; Prostatic neoplasms