A Comparative Analysis of Sextant and Extended 5 – Region 13 Core Transrectal Ultrasound Guided Prostate Biopsy

Abstract

Objective:  To compare the diagnostic value of Exten-ded 5 – Region (13 core) Trans-rectal Ultrasound gui-ded Prostate Biopsy with Standard Sextant Biopsy.

Materials and Methods:  60 patients underwent tra-nsrectal ultrasound guided biopsy of prostate. In addi-tion to sextant biopsies, cores were taken from far late-ral and mid regions of the gland. Pathological findings of the additional regions were compared to those of the sextant regions.

Results:  We performed 5 – region trans-rectal ultra-sound guided prostate biopsy of 60 patients The reason for biopsy was abnormal digital rectal examination in 10 patients (16.7%), elevated PSA in 26 (43.3%) and combined abnormalities in 24 (40%). Out of these 60 cases, 37 (61.6%) came out to have prostate cancer. Of the cancer patients 5 (13.5% had an abnormal digital rectal examination, 14 (37.8%) had elevated PSA and 18 (48.6%) had both abnormalities. Among these 37 positive for carcinoma prostate cases, 22 patients were positive for prostate cancer in additional (zone 1, 3, 5) as well as sextant regions(zone 2, 4), 12 patients had cancer only in additional region 1, 3 and 5 and 3 pati-ents were positive for prostate cancer in sextant regi-ons alone.

Conclusion:  Five region technique of prostate biopsy is an efficient mean of significantly increasing the dia-gnostic yield of prostate biopsy in finding carcinoma of the prostate. We have found this technique to be safe, efficacious and superior to sextant biopsies in diagnosing prostate cancer in patients with a PSA level of less than 10 ng / ml.

Key Words:  Sextant and extended systematic 5 – region trans-rectal ultrasound guided prostate biopsy, Carcinoma of prostate.