Variables Affecting the Histological Quality of Prostate Core Biopsy Samples in Cancer Detection.

Abstract

The examination of the prostate biopsy procedure is essential in the optimization of the diagnostic pathway of such a prevalent affliction as prostate cancer among men worldwide. With the core needle biopsy being the standard of care for the diagnosis of prostate cancer, the ability to obtain quality core samples is directly related to patient treatment and diagnostic reliability. Needle deflection and dynamic tissue deformation are two chief sources of unrepresentative samples outside of human error. To assess how these factors affect overall histological sample quality and what variables influence deflection and deformation, a review of related literature was conducted. A literature search using keywords [(core prostate) OR (prostate)] AND [(biopsy) OR (needle)] AND [(histological) OR (fragmentation) OR (deflection) OR (deformation)] AND [(factors) OR (rate) OR (quality)]. The resulting articles were analysed for relevance of factors influencing histological sample quality. The objective of this review was to analyse trends in the literature and comprise a comprehensive analysis regarding the factors that positively and negatively affect the final histological quality of the core specimens. The results highlighted the velocity of needle insertion into the soft tissue as a variable affecting dynamic deformation, and the geometry of the bevelled biopsy needle tip combined with the application of a biopsy template impacting the deviation of the needle from the linear target. Friction forces also significantly influence the final product as related to these factors. This literature study highlights the crucial parameters of the biopsy procedure and provides for a basis to discuss the improvements to the system and its external components to improve overall patient care. This suggests further investigation of these factors through their manipulation in controlled environments is necessary to improve the effectiveness of the biopsy procedure.