title: True targeting-derived prostate biopsy: HistoScanning™ remained inadequate despite advanced technical efforts.
abstract: OBJECTIVE
  To verify the reliability of HistoScanning™-based, true targeting (TT)-derived prostate biopsy.
  
  
  METHODS
  We relied on 40 patients suspicious for prostate cancer who underwent standard and TT-derived prostate biopsy. Sensitivity, specificity, positive predictive value, negative predictive value and the area under the curve (AUC) were assessed for the prediction of biopsy results per octant by HistoScanning™, using different HistoScanning™ signal volume cutoffs (>0, >0.2 and >0.5 ml).
  
  
  RESULTS
  Overall, 319 octants were analyzed. Of those, 64 (20.1 %) harbored prostate cancer. According to different HistoScanning™ signal volume cutoffs (>0, >0.2 and >0.5 ml), the AUCs for predicting biopsy results were: 0.51, 0.51 and 0.53, respectively. Similarly, the sensitivity, specificity, positive predictive and negative predictive values were: 20.7, 78.2, 17.4 and 81.6 %; 20.7, 82.0, 20.3 and 82.3 %; and 12.1, 94.6, 33.3 and 82.9 %, respectively.
  
  
  CONCLUSIONS
  Prediction of biopsy results based on HistoScanning™ signals and TT-derived biopsies was unreliable. Moreover, the AUC of TT-derived biopsies was low and did not improve when additional signal volume cutoffs were applied (>0.2 and >0.5 ml). We cannot recommend a variation of well-established biopsy standards or reduction in biopsy cores based on HistoScanning™ signals.
authors.affiliation: Department of Urology, Academic Hospital Braunschweig, Salzdahlumerstrasse 90, 38126, Brunswick, Germany. schiffmann.jonas@gmx.de.
authors.forename: Jonas
authors.initials: J
authors.lastname: Schiffmann
authors.affiliation: Department of Urology, Medical University Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Gisa
authors.initials: G
authors.lastname: Mehring
authors.affiliation: Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tennstedt
authors.affiliation: Department of Urology, Academic Hospital Braunschweig, Salzdahlumerstrasse 90, 38126, Brunswick, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Manka
authors.affiliation: Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
authors.forename: Katharina
authors.initials: K
authors.lastname: Boehm
authors.affiliation: Department of Urology, Medical University Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Sami-Ramzi
authors.initials: SR
authors.lastname: Leyh-Bannurah
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.|Department of Urology, University of Montreal Health Center, Montreal, Canada.
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.affiliation: Department of Urology, Academic Hospital Braunschweig, Salzdahlumerstrasse 90, 38126, Brunswick, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hammerer
authors.affiliation: Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.affiliation: Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Salomon
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results
keywords: HistoScanning™; Imaging; Prostate biopsy; Prostate cancer; True targeting; Ultrasound