title: The characteristics and spatial distributions of initially missed and rebiopsy-detected prostate cancers.
abstract: OBJECTIVE
  The purpose of this study was to analyze the characteristics of initially missed and rebiopsy-detected prostate cancers following 12-core transrectal biopsy.
  
  
  METHODS
  A total of 45 patients with prostate cancers detected on rebiopsy and 45 patients with prostate cancers initially detected on transrectal ultrasound-guided biopsy were included in the study. For result analysis, the prostate was divided into six compartments, and the cancer positive rates, estimated tumor burden, and agreement rates between biopsy and surgical specimens, along with clinical data, were evaluated.
  
  
  RESULTS
  The largest mean tumor burden was located in the medial apex in both groups. There were significantly more tumors in this location in the rebiopsy group (44.9%) than in the control group (30.1%, P=0.015). The overall sensitivity of biopsy was significantly lower in the rebiopsy group (22.5% vs. 43.4%, P<0.001). The agreement rate of cancer positive cores between biopsy and surgical specimens was significantly lower in the medial apex in the rebiopsy group compared with that of the control group (50.0% vs. 65.6%, P=0.035). The cancer positive rates of target biopsy cores and premalignant lesions in the rebiopsy group were 63.1% and 42.3%, respectively.
  
  
  CONCLUSIONS
  Rebiopsy-detected prostate cancers showed different spatial distribution and lower cancer detection rate of biopsy cores compared with initially diagnosed cancers. To overcome lower cancer detection rate, target biopsy of abnormal sonographic findings, premalignant lesions and medial apex which revealed larger tumor burden would be recommended when performing rebiopsy.
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.|Department of Radiology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Myung-Won
authors.identifier: 0000-0001-6262-5784
authors.initials: MW
authors.lastname: You
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Mi-Hyun
authors.identifier: 0000-0003-4623-3259
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jeong Kon
authors.identifier: 0000-0001-5987-443X
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kyoung-Sik
authors.identifier: 0000-0002-7846-5583
authors.initials: KS
authors.lastname: Cho
keywords: Image-guided biopsy; Prostatic neoplasms; Ultrasonography