sextant biopsy

sextant biopsy

A series of six biopsies from the right and left upper, middle and lower lobes of the prostate, which increases diagnostic yield and the likelihood of detecting prostate cancer.

sextant biopsy

Urology A series of 6 biopsies from the right and left upper, middle and lower lobes of the prostate, which ↑ diagnostic yield, and likelihood of detecting prostate CA. See Prostate cancer.
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Background: Targeted magnetic resonance (MR)/ultrasound fusion prostate biopsy has been increasingly used in the evaluation of patients with elevated prostate-specific antigen (PSA) following negative standard sextant biopsy and in those patients considering active surveillance.
Objective: To compare the diagnostic accuracy of power Doppler-guided targeted prostate biopsy and random sextant biopsy in the diagnosis of prostate cancer.
Thus, a prostate cancer diagnosis is typically made through TRUS-guided sextant biopsy and histopathological examination.
We obtained specimens from 2400 prostate sextant biopsy cases diagnosed between 1991 and 1997 from both academic and private-practice urologists.
However, biopsy may miss or under-grade prostate cancer: false-negative rates of the first sextant biopsy approach 17%, upgrading on subsequent biopsy approaches 20% and under-grading rates are 30% to 50%.
The laterally directed sextant biopsy and extended biopsy approaches decrease the false-negative rate that occurs with the conventional sextant biopsy approach.
Five of the six centers exclusively performed sextant biopsy, whereas in one center (University Hospital Charite, Berlin), the biopsy strategy was changed in September 1999 from sextant biopsies (n = 517) to octant biopsies (n = 342) with inclusion of two more lateral cores (near the apex).
However, recent reports have indicated that systematic sextant biopsy might be inadequate for cancer detection.
The clinical diagnosis of BPH by digital rectal examination, assessment of the International Prostate Symptom Score, and transrectal ultrasonography was histologically confirmed by examination of tissue specimens obtained by sextant biopsy or after transurethral resection.
Indeed, the introduction of transrectal ultrasound (TRUS)-guided systematic sextant biopsy method by Hodge and colleagues in 1989 revolutionized the early diagnosis of prostate cancer.