Abstract
Objectives This paper aims to provide an explanation for the positive findings of the improved prostate cancer detection rate by the transperineal approach when compared to the transrectal approach. The peripheral zone (PZ) is a region of the prostate with the most cancer occurrence. Hence, the ability to reach it consistently can improve the cancer detection rate significantly.
Methods In a prospective study, ultrasound images taken from five patients were used to reconstruct the prostate, rectum and pubic bone with the perineal wall data obtained from the same patient. Each anatomical model virtually underwent prostate biopsy transperineally and transrectally with 10 cores biopsy each. We assessed the efficacy by calculating the volume of PZ tissue obtained from each approach.
Results The overall volume of virtual core tissue taken from the PZ was 81.7% from a total volume of 100 prostate biopsy cores. Of the volume of tissue extracted transperineally, 98.5% was from the PZ compared to only 64.9% of the transrectally extracted tissue.
Conclusions This is the first paper that acquires and reconstructs the virtual anatomy of the prostate, rectum and pubic bone with the perineal wall. Transperineal biopsy is superior to the transrectal method in obtaining the peripheral zone tissue. This explains the findings that the prostate cancer detection rate is higher via the transperineal approach.
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Mohan, P., Ho, H., Yuen, J. et al. A 3D computer simulation to study the efficacy of transperineal versus transrectal biopsy of the prostate. Int J CARS 1, 351–360 (2007). https://doi.org/10.1007/s11548-007-0069-5
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DOI: https://doi.org/10.1007/s11548-007-0069-5