Transrectal real-time elastography-guided transperineal prostate biopsy as an improved tool for prostate cancer diagnosis.

OBJECTIVES The aim of this study is to determine the utility of transrectal real-time elastography (TRTE)-guided prostate biopsies in patients subjected to transrectal ultrasound (TRUS)-guided transperineal prostate biopsies. MATERIALS AND METHODS A total of 108 consecutive patients suspicious for prostate cancer (PCa) with elevated serum prostate specific antigen (PSA) level > 4 μg/L or abnormal findings on digital rectal examination (DRE) were enrolled in this study. All patients were sequentially underwent 10-cores systematic biopsy and TRTE-guided targeted biopsy. The detection rate of the TRTE-guided targeted biopsy was compared with that of the TRUS-guided 10-cores systematic biopsy, in combination with prostate biopsy pathology. RESULTS 38 cases among 108 suspicious patients were diagnosed as PCa using the TRUS-guided 10-cores systematic biopsy with a detection rate of 35.2%. Subsequently, a further increase of 13.9% (15/108, P = 0.039) in PCa detection was obtained by the TRTE-guided targeted biopsy. The overall detection rate for PCa was 49.1% (53/108). A total of 1296 cores were sampled among the 108 patients, including 1080 cores for the 10-cores systematic biopsy and 216 cores for the TRTE-guided targeted biopsy cores. The positive rate of the TRTE-guided targeted biopsy was significantly higher than that of the TRUS-guided 10-cores systematic biopsy (50.9% versus 14.1%, P < 0.0001). CONCLUSIONS TRTE-guided targeted biopsy could be used as a complement to significantly improve the detection rate for PCa in clinical setting.