Ultrasound for prostate biopsy

The evaluation of prostatic conditions prior to the advent of sonographic techniques relied on palpation of the gland and "blind" sampling techniques via needle aspiration and biopsy. With the development of B-mode ultrasound in the 1950s, and probes capable of providing images to the clinician in real-time, gray-scale ultrasound became the standard method of prostate imaging for most prostate conditions. The position of the prostate in the pelvis, tucked as it were beneath the pubis and anterior to the rectum, lends itself to the application of a transrectal approach. The transrectal approach to imaging the gland has become the standard of care for the diagnostic evaluation of prostatic conditions, prostate biopsy, and therapeutic approaches to prostate cancer. In addition, the transperineal approach used for saturation biopsies and the advent of MRI fusion biopsy techniques have been important tools in the armamentarium of the urologist.