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If a subject had multiple negative biopsies, we analyzed the first biopsy that could be linked to a PSA test within the preceding 12 months.
First, in men with persistently raised serum prostate-specific antigen (PSA) levels and in whom there have been multiple negative biopsies or positive but low-grade low-volume tumour with discordant PSA kinetics; it is estimated that up to 30 50% of these men have undiagnosed, clinically significant cancers.
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MR-TRUS fusion biopsy also improves cancer detection rates in patients with enlarged prostates and patients with a history of multiple prior negative biopsies, in whom detection rates are lower via conventional random biopsy techniques.
Deciding on strategy for patients with minor lower urinary tract symptoms (LUTS), elevated prostate-specific antigen (PSA) levels, unsuspicious digital rectal examination (DRE) and/or transrectal ultrasound (TRUS), and multiple negative extended prostate biopsies is complex.
Hambrock et al. found a cancer detection rate of 59%, in men with an elevated PSA and multiple negative TRUS-Bx (≥2) sessions, for magnetic-resonance guided biopsies (MRGBx).
None of the five patients with biopsies consistent with sarcoidosis were on topical corticosteroids at the time of biopsy, while two patients with negative biopsies were on topical corticosteroid drops for at least 1 month before biopsy.
MpMRI can guide targeted rebiopsy in patients with previous negative biopsies.
Underestimation can occur as a result of false negative biopsies.
False negative biopsies can also occur under ductoscopic visualisation.
The specificity will be calculated as the number of truly negative tests (ie, negative MRI with a concurring negative biopsy) divided by the total number of negative biopsies.
In contrast, a very important number is the ratio of true-negative biopsies to all negative biopsies (false negatives plus true negatives).
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