Transrectal ultrasound guided prostate biopsy

Abstract

Prostate biopsy (PBx) is one of the most common urological procedures, with more than one million procedures performed per year in Europe and the United States. PBx is performed to diagnose prostate cancer (PCa) that may be considered as a singular malignancy despite other neoplastic diseases for which the biopsy can be direct to a single suspect area. At present, PBx is can be carried out in an office setting with low morbidity however the role of prostate biopsy (PBx) has changed and its findings play a crucial role in the choice of prostate cancer treatment. For instance, the recent introduction of active surveillance and focal therapy as ideally available treatment options have emphasized the role of PBx to assist patient clinical management requiring persuasive details on PCa quality. Likewise, in the effort to improve both the cancer detection and the cancer features assessment a notable improvement in PBx instrumentations and technologies has occurred over the last years moving from Vim-Silverman needle originally used in the 1980 to perform digital-guided PBx to many imaging technologies such as elastosonography or magnetic resonance aimed to improve the PCa detection. PBx can be carried out by both perineal and trans rectal approach. Herein, main technical aspects of the trans rectal prostate biopsy are summarized in order to provide the most current knowledge on this topic.