World Journal of Urology

, Volume 36, Issue 4, pp 623–628 | Cite as

Prostate cancer rates in patients with initially negative elastography-targeted biopsy vs. systematic biopsy

  • Jeannette Kratzenberg
  • Georg Salomon
  • Pierre Tennstedt
  • Paolo Dell’Oglio
  • Derya Tilki
  • Axel Haferkamp
  • Markus Graefen
  • Katharina Boehm
Original Article



To assess whether real-time elastography-targeted biopsy (RTE-bx) is superior to the standard systematic transrectal ultrasound (TRUS)-guided biopsy in predicting subsequent prostate cancer (PCa) rates in patients with initially negative biopsy and to specifically reveal differences in the occurrence of high-grade (Gleason ≥ 4 + 3) PCa by comparing both biopsy methods.

Patients and methods

Overall, 630 patients had an initially negative prostate biopsy between 2007 and 2015, either RTE targeted (n = 213) or systematically (n = 417). Follow-up data, ascertained by a questionnaire, of patients receiving RTE-bx were compared to data of patients receiving systematic biopsy (sbx) using Mann–Whitney-U test and Chi-square test. We performed logistic regression analyses to assess any association with PCa or high-grade PCa occurrence.


In total, 258 (41%) patients were diagnosed with PCa at repeat biopsy whereof 54 (8.6%) harboured high-grade PCa. PCa occurred in 95 (44.6%) patients with initially negative RTE-bx and in 163 (39.1%) patients with initially negative sbx (p = 0.003). 24 (11.3%) patients receiving RTE-bx and 30 (7.2%) patients receiving sbx were diagnosed with high-grade PCa (p = 0.095). Logistic regression analyses showed that patients with the initial RTE-bx vs. those with the initial sbx neither resulted in a significant higher risk for PCa occurrence (OR 1.35 [CI 0.87–2.1]; p = 0.2) nor for high-grade PCa occurrence (OR 1.52 [CI 0.66–3.35]; p = 0.3).


We found no statistically significant association of prior biopsy method to subsequent PCa or high-grade PCa occurrence. Referring to our analyses, RTE is not superior to sbx in predicting subsequent PCa rates and, therefore, not eligible to decide on repeat biopsy.


Prostate biopsy Targeted biopsy Oncological outcome Negative biopsy 


Author contributions

Protocol/project development: KB, JK, GS, and PD. Data collection or management: GS and PT. Data analysis: KB, PT, and JK. Manuscript writing/editing: JK, KB, GS, AH, MG, and DT.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the local ethics board, and all subjects provided written informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jeannette Kratzenberg
    • 1
  • Georg Salomon
    • 1
  • Pierre Tennstedt
    • 1
  • Paolo Dell’Oglio
    • 2
  • Derya Tilki
    • 1
    • 3
  • Axel Haferkamp
    • 4
  • Markus Graefen
    • 1
  • Katharina Boehm
    • 1
    • 4
  1. 1.Martini-Clinic, Prostate Cancer CentreUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Unit of Urology, Division of Oncology, URIIRCCS Ospedale San RaffaeleMilanItaly
  3. 3.Department of UrologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Department of UrologyUniversity Medical Center, Johannes Gutenberg UniversityMainzGermany

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