Mai Z, et al. - The purpose of this study was to compare the characteristics of detected and undetected lesions by template-guided transperineal saturation prostate biopsy and evaluate the potential impact of undetected lesions. It has been validated that template-guided transperineal saturation prostate biopsy could detect about two-thirds of clinically significant lesions. Moreover, most of the undetected ones were those with small tumour volume. Importantly, approximately 20-30% of patients had undetected clinically significant lesions in a different lobe or quadrant comparing with the detected ones in the biopsy.

Methods

• Clinicians examined the characteristics of lesions in radical prostatectomy (RP) specimens, compared the differences between detected and undetected lesions by systematic transperineal ultrasound guided 11-region biopsy in tumour volume, Gleason score, surgical margin, spatial location and clinical significance, and assessed the potential impact of undetected clinical significant lesions.

Results

• In this study, 24 was the median number of biopsy cores.
• They detected 64% of the clinically significant lesions (170/264).
• They found significant differences between the detected and undetected lesions in tumour volume, Gleason score and clinical significance.
• The inconsistency of lesion position between biopsy and RP specimens in the anterior and posterior zones and the left and right sides were 3.4% (7/203) and 5.4% (11/203), respectively.
• Of the 129 patients, 13 (10.1%) had undetected clinically significant lesions in the biopsy lying on the same side but in a different zone from the detected clinically significant lesions, whereas 23 (17.8%) cases had undetected clinically significant lesions in the biopsy lying on the opposite side from the detected clinically significant lesions.