True targeting-derived prostate biopsy: HistoScanning™ remained inadequate despite advanced technical efforts

To verify the reliability of HistoScanning (TM)-based, true targeting (TT)-derived prostate biopsy. We relied on 40 patients suspicious for prostate cancer who underwent standard and TT-derived prostate biopsy. Sensitivity, specificity, positive predictive value, negative predictive value and the area under the curve (AUC) were assessed for the prediction of biopsy results per octant by HistoScanning (TM), using different HistoScanning (TM) signal volume cutoffs (> 0, > 0.2 and > 0.5 ml). Overall, 319 octants were analyzed. Of those, 64 (20.1 %) harbored prostate cancer. According to different HistoScanning (TM) signal volume cutoffs (> 0, > 0.2 and > 0.5 ml), the AUCs for predicting biopsy results were: 0.51, 0.51 and 0.53, respectively. Similarly, the sensitivity, specificity, positive predictive and negative predictive values were: 20.7, 78.2, 17.4 and 81.6 %; 20.7, 82.0, 20.3 and 82.3 %; and 12.1, 94.6, 33.3 and 82.9 %, respectively. Prediction of biopsy results based on HistoScanning (TM) signals and TT-derived biopsies was unreliable. Moreover, the AUC of TT-derived biopsies was low and did not improve when additional signal volume cutoffs were applied (> 0.2 and > 0.5 ml). We cannot recommend a variation of well-established biopsy standards or reduction in biopsy cores based on HistoScanning (TM) signals.