OBJECTIVE: Systematic sextant biopsies are a powerful tool in the diagnosis of prostate cancer. Interpretation of the histopathologic results of these biopsies plays a central role in treatment decisions. This biopsy approach was originally described as sampling the prostate in the mid-lobe, parasagittal plane at the apex, mid-gland, and base, bilaterally. Morphometric analysis of prostate specimens has revealed that most clinically significant cancers are mainly located in the posterolateral aspect of the gland, not the mid-lobe. We sought to determine if cancer detection could be improved by obtaining more laterally placed biopsies. MATERIALS AND METHODS: Forty-one patients underwent transrectal ultrasound with mid-lobe sextant as well as lateral sextant biopsies. Biopsy specimens were evaluated for Gleason grade and length of cancer present in each core. The mid-lobe and lateral biopsy results were then compared. RESULTS: Thirteen of 41 patients (31.7%) were found to have no cancer on either biopsy set. Cancer was detected by both the mid-lobe and the lateral biopsies in 19 patients (46.3%). In 6 patients (14.6%), only the lateral biopsies revealed cancer, and in 3 patients (7.3%), only the mid-lobe biopsies revealed cancer. CONCLUSIONS: Laterally-placed systematic sextant biopsies may yield an improved diagnosis rate in patients with palpable nodularity in the lateral aspect of the prostate, patients without any palpable abnormalities but with elevated PSA levels, and in those patients undergoing repeat biopsies.
OBJECTIVE: Systematic sextant biopsies are a powerful tool in the diagnosis of prostate cancer. Interpretation of the histopathologic results of these biopsies plays a central role in treatment decisions. This biopsy approach was originally described as sampling the prostate in the mid-lobe, parasagittal plane at the apex, mid-gland, and base, bilaterally. Morphometric analysis of prostate specimens has revealed that most clinically significant cancers are mainly located in the posterolateral aspect of the gland, not the mid-lobe. We sought to determine if cancer detection could be improved by obtaining more laterally placed biopsies. MATERIALS AND METHODS: Forty-one patients underwent transrectal ultrasound with mid-lobe sextant as well as lateral sextant biopsies. Biopsy specimens were evaluated for Gleason grade and length of cancer present in each core. The mid-lobe and lateral biopsy results were then compared. RESULTS: Thirteen of 41 patients (31.7%) were found to have no cancer on either biopsy set. Cancer was detected by both the mid-lobe and the lateral biopsies in 19 patients (46.3%). In 6 patients (14.6%), only the lateral biopsies revealed cancer, and in 3 patients (7.3%), only the mid-lobe biopsies revealed cancer. CONCLUSIONS: Laterally-placed systematic sextant biopsies may yield an improved diagnosis rate in patients with palpable nodularity in the lateral aspect of the prostate, patients without any palpable abnormalities but with elevated PSA levels, and in those patients undergoing repeat biopsies.
Authors: Axel Krieger; Iulian I Iordachita; Peter Guion; Anurag K Singh; Aradhana Kaushal; Cynthia Ménard; Peter A Pinto; Kevin Camphausen; Gabor Fichtinger; Louis L Whitcomb Journal: IEEE Trans Biomed Eng Date: 2011-11 Impact factor: 4.538
Authors: Helen Xu; Andras Lasso; Siddharth Vikal; Peter Guion; Axel Krieger; Aradhana Kaushal; Louis L Whitcomb; Gabor Fichtinger Journal: Med Image Comput Comput Assist Interv Date: 2010
Authors: Axel Krieger; Sang-Eun Song; Nathan B Cho; Iulian Iordachita; Peter Guion; Gabor Fichtinger; Louis L Whitcomb Journal: IEEE ASME Trans Mechatron Date: 2011-10-17 Impact factor: 5.303
Authors: Helen Xu; Andras Lasso; Peter Guion; Axel Krieger; Aradhana Kaushal; Anurag K Singh; Peter A Pinto; Jonathan Coleman; Robert L Grubb; Jean-Baptiste Lattouf; Cynthia Menard; Louis L Whitcomb; Gabor Fichtinger Journal: Int J Comput Assist Radiol Surg Date: 2013-03-27 Impact factor: 2.924