Template-guided biopsy delivers higher prostate cancer detection rate

Use of a novel template-guided prostate biopsy system potentially produces a higher cancer detection rate and more accurate assessment of grade, according to an article in the British Journal of Urology (2008; 102:546-50).

The TargetScan biopsy technology (Envisioneering Medical Technology, St. Louis) combines 3-D image acquisition with a stationary probe, which helps physicians plan and execute targeted prostate biopsies through accurate needle placement within a template that, in turn, can provide confidence in identifying locations of significant cancer in the prostate.

In the study, cancer was detected in 50 (35.7%) of the 140 patients biopsied, including 39 (47.6%) with no previous biopsies. Of 23 prostatectomy specimens, 20 (87%) had pathologically significant disease.

The biopsy predicted the prostatectomy Gleason score in 12 patients (52%), overestimated in two (9%) and underestimated in eight (35%). Biopsy Gleason score could not be assigned in one patient (4%).

“As physicians, we are challenged to provide accurate diagnosis and define the true extent of the disease so we don’t over or underestimate the significance of the cancer,” said study co-author Gerald Andriole, MD of the Washington University School of Medicine in St. Louis.

“This technology allows physicians to accurately biopsy the prostate since the location of each biopsy is calculated on the basis of the prostate’s size and shape,” added lead author Adam Kibel, MD. “This may allow us to more accurately find and define the disease. Importantly, since the location of each biopsy site is recorded, re-biopsy or treatments can be performed with more precision.”