Utility of Histoscanning™ prior to prostate biopsy for the diagnosis of prostate adenocarcinoma ☆

Abstract Objectives HistoScanning™ (HS) is a method of ecographic diagnosis of prostate cancer. We analyze the effectiveness of the HS realization prior to the biopsys for the prostate adenocarcinoma diagnosis. Materials and methods From August to October 2012 we have carried out a study with HS prior to the biopsys in 32 patients. In all cases sextants transrectalbiopsys have been realized (two cores in each sextant) in the periphery zone. In those sextants in which there were suspicious areas with HS, the biopsys were addressed to those areas. Transperinealbiopsys were added to those zones placed in the half-front or apical prostatic zone. The medium age was 63.7 years (range 40–82) with a medium PSA of 8.0 ng/ml (range 3.5–36.2) and a medium prostatic volume of 46.6 cc (range 18.2–103.2). In eight cases it was the first biopsy, in 14 cases they were repetition biopsys and 10 patients had a previous diagnosis of prostate adenocarcinoma (8 in a program of active surveillance and 2 T1a in RTU of previous prostate). Results In the 32 patients a medium of 7.5 zones were biopsed (range 6–9) with a total of 239 zones studied. There were identified a medium of 3.2 zones with suspictious areas (ZS) with HS (range 2–5) with a total of 103 ZS. In 72 zones of 25 patients it was found adenocarcinoma or PIN (2 PIN, 11 score Gleason 6, 7 score Gleason 7, 3 score Gleason 8 and 2 score Gleason 9). There were 35 positive falses zones in 20 patients (11 normal parenquima and 9 cronic inflammation). False negatives were produced in 5 zones in 5 patients (2 PIN, 2 score Gleason 6 and 1 score Gleason 7) although in all 5 cases adenocarcinoma was encountered (0 discovered) in other zones. The HS presented a sensibility of a 93.5% with a specificity of 79.5%. The positive predictive value was of the 67.35% with a negative predictive value of 96.5%. Conclusions In spite of being a selected series, with a high rate of patients with adenocarcinoma, the exploration with HS has presented a great sensibility and a high negative predictive value. These data, although they must be confirmed in less selected series, state that the prior exploration with HS can help both in the diagnosis in the biopsies and in the follow-up of programs of active surveillance.