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Review
. 2022 Jun 26:14:17562872221105019.
doi: 10.1177/17562872221105019. eCollection 2022 Jan-Dec.

Schema and cancer detection rates for transperineal prostate biopsy templates: a review

Abhinav Sidana  1 , Fernando Blank  2 , Hannah Wang  2 , Nilesh Patil  2 , Arvin K George  3 , Hasan Abbas  2
Affiliations
Review

Schema and cancer detection rates for transperineal prostate biopsy templates: a review

Abhinav Sidana et al. Ther Adv Urol. .

Abstract

Prostate cancer (PCa) is the most common noncutaneous malignancy in men and is the second leading cause of cancer mortality in men in the United States. Current practice requires histopathological confirmation of cancer achieved through biopsy for diagnosis. The transrectal approach for prostate biopsy has been the standard for several decades. However, the risks and limitations of transrectal biopsies have led to a recent resurgence of transperineal prostatic biopsies. Recent studies have demonstrated the transperineal approach for prostate biopsies to be effective, associated with minimal complications and superior in several aspects to traditional transrectal biopsies. While sextant and extended sextant templates are widely accepted templates for transrectal biopsy, there are a diverse set of transperineal biopsy templates available for use, without consensus on the optimal sampling strategy. We aim to critically appraise the salient features of established transperineal biopsy templates.

Keywords: 10-sector template; 12-core; Barzell technique; Ginsburg protocol; prostate cancer; prostate mapping; transperineal template biopsies.

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Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Prostate anatomy zones with cancer frequency.
Figure 2.
Figure 2.
Eight-sector Barzell template. AS, anterior fibromuscular stroma; LAA, left anterior apex; LAB, left anterior base; LPA, left posterior apex; LPB, left posterior base; PZ, peripheral zone; RAA, right anterior apex; RAB, right anterior base; RPA, right posterior apex; RPB, right posterior base; TZ, transition zone.
Figure 3.
Figure 3.
Twenty-sector modified Barzell. AS, anterior fibromuscular stroma; LL, left lateral; LMAP, left medial anterior apex; LMAB, left medial anterior base; LMPA, left medial posterior apex; LMPB, left medial posterior base; LPAP, left parasagittal anterior apex; LPAB, left parasagittal anterior base; LPPA, left parasagittal posterior apex; LPPB, left parasagittal posterior base; MA, midline apex; MB, midline base; PZ, peripheral zone; RL, right lateral; RMAP, right medial anterior apex; RMAB, right medial anterior base; RMPA, right medial posterior apex; RMPB, right medial posterior base; RPAP, right parasagittal anterior apex; RPAB, right parasagittal anterior base; RPPA, right parasagittal posterior apex; RPPB, right parasagittal posterior base; TZ, transition zone.
Figure 4.
Figure 4.
Ginsburg protocol template.
Figure 5.
Figure 5.
Transperineal 12-core biopsy template. AS, anterior fibromuscular stroma; PZa, peripheral zone anterior; PZpl, peripheral zone posterior lateral; PZpm, peripheral zone posterior medial; TZa, transition zone anterior; TZp, transition zone posterior.
Figure 6.
Figure 6.
Fan technique method as described by Emiliozzi et al.
Figure 7.
Figure 7.
Ten-sector template. LAL, left anterior lateral; LAM, left anterior medial; LLB, left lateral base; LPL, left posterior lateral; LPM, left posterior medial; RAL, right anterior lateral; RAM, right anterior medial; RLB, right lateral base; RPL, right posterior lateral; RPM, right posterior medial.
Figure 8.
Figure 8.
MUSIC template. LA, left anterior; LL, left lateral; LPA, left posterior apex; LPB, left posterior base; LPMA, left paramedian apex; LPMB, left paramedian base; RA, right anterior; RL, right lateral; RPA, right posterior apex; RPB, right posterior base; RPMA, right paramedian apex; RPMB, right paramedian base.
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