Clinical-Pathologic Correlation Between Transperineal Mapping Biopsies of the Prostate and Three-Dimensional Reconstruction of Prostatectomy Specimens

BACKGROUND Extended transrectal ultrasound guided biopsies (TRUSB) of the prostate may not accurately convey true morphometric information and Gleason score (GS) of prostate cancer (PCa) and the clinical use of template‐guided (5‐mm grid) transperineal mapping biopsies (TPMBs) remains controversial. METHODS We correlated the clinical‐pathologic results of 1,403 TPMB cores obtained from 25 men diagnosed with PCa with 64 cancer lesions found in their corresponding radical prostatectomy (RP) specimens. Special computer models of three‐dimensional, whole‐mounted radical prostatectomy (3D‐WMRP) specimens were generated and used as gold standard to determine tumor morphometric data. Between‐sample rates of upgrade and downgrade (highest GS and a novel cumulative GS) and upstage and downstage (laterality) were determined. Lesions ≥ 0.5 cm3 or GS ≥ 7 were considered clinically significant. RESULTS From 64 separate 3D‐WMRP lesions, 25 had significant volume (mean 1.13 cm3) and 39 were insignificant (mean 0.09 cm3) (P