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Urol Clin North Am. 2014 May;41(2):327-38. doi: 10.1016/j.ucl.2014.01.010.

Management of an increasing prostate-specific antigen level after negative prostate biopsy.

Author information

1
Department of Urology, University of California, San Francisco, 1600 Divisadero Street A-634, San Francisco, CA 94143-1695, USA. Electronic address: kshinohara@urology.ucsf.edu.
2
Department of Urology, University of California, San Francisco, 1600 Divisadero Street A-634, San Francisco, CA 94143-1695, USA.

Abstract

Patients who have a previously negative biopsy in the setting of clinical suspicion of prostate cancer still have a high risk of harboring significant undiagnosed disease. Various markers such as prostate-specific antigen (PSA) velocity, PSA density, PCA3, and newer markers may aid in repeat biopsy selection. Repeating the same biopsy procedure in such patients does not yield high cancer detection rates. More anteriorly directed transrectal or transperineal biopsies are indicated. Multiparametric magnetic resonance imaging can detect abnormal areas, and lesion-targeted biopsies can improve the cancer detection rate.

KEYWORDS:

Anterior cancer; Multiparametric magnetic resonance imaging; PCA3; Repeat prostate biopsy; Transperineal prostate biopsy; Transrectal ultrasonography

PMID:
24725493
DOI:
10.1016/j.ucl.2014.01.010
[Indexed for MEDLINE]

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