title: [Value of perineal HistoScanning™ template-guided prostate biopsy].
abstract: BACKGROUND
  Modern imaging modalities improve prostate diagnostics.
  
  
  OBJECTIVE
  This study was performed to determine the outcome characteristics of biopsy procedures using the results of HistoScanning(TM) analysis (HS) for identifying prostate cancer (PCa) in patients with perineal template-guided prostate biopsy.
  
  
  METHODS
  A total of 104 consecutive men (mean age 69 years, mean PSA 9.9 ng/ml) underwent HS prior to the extended prostate biopsy procedure. Patients received a targeted transperineal (template-assisted) as well as a targeted transrectal prostate biopsy using HS projection reports supplemented by a standardized 14-core systematic transrectal prostate biopsy (Bx). The cancer detection rate was analyzed on the sector level and HS targeted results were correlated to biopsy outcome, sensitivity, specificity, predictive accuracy, negative predictive value (NPV) and positive predictive value (PPV).
  
  
  RESULTS
  Of 104 patients, 44 patients (42%) were found to have PCa. Histology detected atypical small acinar proliferation in 3 patients (2.9%), high-grade prostatic intraepithelial neoplasia in 16 (15.4%), and chronic active inflammation in 74 (71.1%), respectively. The detection rate for each region was significantly higher in HS-targeted biopsies compared to Bx. The detection rate per patient was not significantly different, although a smaller number of regions were biopsied with the targeted approach. The overall sensitivity, specificity, predictive accuracy, NPV, and PPV on the sector level were 37.2, 85.6, 78.6, 88.7 and 30.8%, respectively.
  
  
  CONCLUSIONS
  The use of HS analysis results in a higher detection rate of prostate cancer compared to common transrectal ultrasonography (TRUS)-guided Bx. This technique increases the informative value of TRUS imaging and improves the diagnostic impact at least in the targeted biopsy setting.
authors: Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland. moritz.hamann@uksh.de.
authors: M F
authors: MF
authors: Hamann
authors: Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.
authors: C
authors: C
authors: Hamann
authors: Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.
authors: D
authors: D
authors: Olzem
authors: Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.
authors: A
authors: A
authors: Trettel
authors: Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.
authors: K P
authors: KP
authors: Juenemann
authors: Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.
authors: C M
authors: CM
authors: Naumann
mesh_terms: D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D010363:Pattern Recognition, Automated / Q000379:methods; D010502:Perineum / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
keywords: Early detection of cancer; High-intensity focused, transrectal; Prostate cancer; Prostatic intraepithelial neoplasia; Prostatitis