TRUS biopsy Vs Template biopsy
When it comes to biopsy procedures, prostate cancer patients are usually offered the standard TRUS biopsy (Trans-Rectal UltraSound-guided). Typically, up to twelve needle samples are collected from the rear of the prostate (the front is inaccessible), using a probe that’s inserted via the rectum.
Cancer diagnoses can be missed whenever false negative biopsy results are produced; TRUS biopsies are notorious for this, because cancer in inaccessible parts of the prostate can go undetected. Also, a non-specific pattern is used to determine where biopsy tissue samples should be taken; far fewer samples are collected too, meaning TRUS biopsy results can produce low accuracy levels.
Template biopsies for prostate cancer
Unlike the TRUS biopsy and its non-specific method of locating suitable biopsy sites, Template biopsies use an alpha-numerical template of holes to accurately pre-determine the best areas of the prostate for taking biopsy tissue samples. The ability to pinpoint targeted areas, and the ability to access the front of the prostate both help produce greater result accuracy, with fewer false negatives.
What do Template biopsies involve?
Patients will be advised throughout, about this twenty minute procedure. Typically, patients will receive a local anaesthetic; although general anaesthetics can improve patient comfort, they must arrange transportation (no driving) and companionship (where possible), for the following forty-eight hour period… this includes returning home from hospital following treatment.
Once anaesthetised, a catheter is inserted to locate the urethra and to avoid needle contact with it. Targeted biopsies usually collect around twenty to forty tissue samples, whereas saturation biopsies usually collect thirty to fifty. The sites of this sample taking is dictated by mapping out MRI scans over the prostate. The catheter is removed following the collection of tissue samples.
Targeted and saturation template biopsies
Depending on the intended procedure, either a targeted or saturation template biopsy will be used. Where prostate cancer has already been identified and located, the targeted template biopsy will be used. Saturation template biopsies map the whole prostate and as many as fifty tissue samples are taken during this thorough assessment of the prostate.
Possible side-effects¹
There are numerous side-effects associated with the Template biopsy procedure; these impact patients to varying degrees (if at all). Discomfort or pain, short-term bleeding, infection, acute urine retention or sexual issues, are all common complaints; patients should be consulted regarding any symptoms or physical limitations and have any personal questions answered.
When will I get my results?
Test results won’t be available on the same day of your procedure; biopsy sample results will be included in a pathology report, which is sent to your doctor, but a copy can also be mailed to patients directly (results typically arrive within a fortnight). The pathology report verifies if cancer has been found; with positive results, the location and size of cancer is also included.
¹NICE guidance, Information about NICE interventional procedure guidance 364, October 2010
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