10-9-2026 Wait Don’t Total the Cores Yet! Applying SSDI Note 4 for Targeted Prostate Biopsies
If you’ve ever struggled with this concept, you’re not alone. This tip outlines different tools and approaches that can help you break it down and reach the correct conclusion.
Scenario:
Patient presents for MRI/US fusion guided prostate biopsy: Targeted biopsies were taken plus 12 biopsies sent as right and left base (lateral, medial), mid (lateral, medial) and apex (lateral, medial).
Below are some steps to help illustrate how to calculate #cores positive/negative
- Review the path report, the final diagnosis supplemented by the gross section and enter the number of cores examined into Excel for all specimens A-M
- Review the path report, the final diagnosis supplemented by the gross section and enter the number of positive cores in Excel for all specimens A-M
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- Below is the Excel Spreadsheet created from steps 1 & 2
3.Per the SSDI manual “Note 4: If there is a targeted biopsy or a region of interest (ROI) biopsy done, count as 1 core positive/1 core examined, regardless of how many cores are actually taken from the targeted/ROI location. When doing a targeted or ROI biopsy, the region being biopsied is suspected of cancer (usually based on an MRI). Since the area is targeted, there will be many more cores removed. To record all these cores would be inflating the numbers.”
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- Don’t forget about targeted biopsies! Specimens A and B were TARGETED biopsies. Although three cores were obtained from Specimen A and two cores from Specimen B, each targeted biopsy is counted as one targeted core, regardless of the number of tissue cores collected . Therefore, Specimen A counts as 1, and Specimen B counts as 1. After applying this rule and revising the counts, the corrected totals are 14 cores examined and 7 cores positive.
