Prostate Cancer Detection by Transrectal Ultrasound Guided Prostate Biopsy: Urology versus Radiology at a Single Academic Institution

Yoon, Byung Il; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung Hoo; Sohn, Dong Wan; Lee, Ji Youl; Hwang, Tae Kon; Kim, Sae Woong

Abstract

PURPOSE
Many centers rely on radiologists to detect prostate cancer by transrectal ultrasound guided prostate biopsy. In this study we evaluated transrectal ultrasound guided prostate biopsy by radiologist or urologist, and compared prostate cancer detection rate, pathologic results and pain scrore. MATERIAL AND METHODS: In all, 259 consecutive patients had transrectal ultrasound guided prostate biopsy by one radiologist (group 1) and one urologist (group 2). The indication for prostate biopsies were a raised or rising prostate specific antigen (PSA) level or abnormal digital rectal examination (DRE). All data were collected prospectively.
RESULTS
Both group showed comparable demographic data in age, PSA, prostate volume. But pain score showed higher in urologist group (p<0.05). Prostate cancer was detected in 73 patients (28.1%). Radiologist detected prostate cancer in 38 patients (29.2%) and urologist detected prostate cancer in 35 patients (27.1%) (p=0.70). Both groups showed comparable cancer detection rates in PSA of <4, 4-10 and >10 ng/ml. Both groups had similar Gleason score (6.8+/-0.7 vs 6.7+/-0.8) and number of cancer cores (3.0+/-1.7 vs 3.9+/-2.3). Group 1 showed significantly low visual analogue pain scale compared with Group 2 (2.9+/-1.9 vs 4.0+/-2.1)(p<0.05).
CONCLUSION
Transrectal ultrasound guided prostate biopsy showed equally reliable datas whether performed by radiologist or urologist. The urologist can effectively perform transrectal ultrasound guided prostate biopsy like radiologist in detecting prostate cancer. Also we recommend to perform anesthesia to relieve pain before prostate biopsy and furthermore future studies with more patients with more datas are needed.