Prostate Cancer Detection with MRI Fusion Biopsy: The Future is Here!

31 Oct 2016

We are proud to offer our patients they very best care available anywhere in the world. We have started to offer our patients MRI-fusion prostate biopsies in an effort to improve their care and outcomes…

Despite many advances in the treatment of advanced prostate cancer, it is still the second most common cancer related cause of death in men behind only lung cancer. Early cancer detection and treatment is an essential step to beating prostate cancer. Screening for prostate cancer involves a rectal exam and a simple blood test referred to as Prostate Specific Antigen, or PSA. Screening should be discussed with all men starting at age 40. Unfortunately, screening for prostate cancer has significantly decreased over the last several years due to poor quality research and conflicting recommendations from national and international organizations. This had delayed efforts to improve outcomes by decreasing early detection when the cancer is still at a curable stage. Fortunately, newer studies continue to support the use of screening as well as discredit previous studies that showed no benefit. With more widespread screening, more men at increased risk of cancer can be identified early. But how do we actually diagnose prostate cancer and what can be done to improve this?

A prostate biopsy is required to diagnose prostate cancer. At Regional Urology this is generally done with the patient sedated in the operating room (we want you to be comfortable). An ultrasound probe is placed in the rectum and used as a guide to visualize the prostate. Twelve random biopsies are taken to “sample” the prostate. Occasionally abnormal areas of the prostate can be seen on the ultrasound; however, this is not very accurate. For patient that are diagnosed with cancer on a biopsy, they can move on to discuss definitive treatment with their Urologist. Unfortunately; patients with negative biopsies are not completely off the hook. As the biopsies are random, prostate cancer can be missed. In fact, it is estimated that up to 30% of patients with negative biopsies still have clinically significant cancer that was unfortunately missed in the random biopsy. Therefore, patients with a negative biopsy still require close follow-up.

During follow-up, routine exams are performed and a patient’s PSA is followed closely. Based on a change in exam or a rise in PSA, your Urologist may recommend a repeat biopsy. But what will be different about this biopsy then the first? That is where a MRI fusion biopsy helps dramatically. A MRI of the prostate is very good at detecting high grade prostate cancers (unlike ultrasound). Our radiologist will review the images and mark any areas of concern. With the use of very advanced computer technology, we can “fuse” these marked images during the biopsy procedure with real-time ultrasound and actually target the concerning areas during the biopsy. No more random biopsies! We are finally able to improve our detection rate after years of relying on the same random sampling technique.

Click to learn more about MRI fusion biopsies.

While it would be ideal to perform a MRI before the initial biopsy, this is currently not covered by Medicare or most insurance companies. The average cost of a MRI is $2,611 and this has not improved much recently. However, as we continue to learn more about how MRI-fusion biopsy is improving the detection of prostate cancer and as the cost of an MRI drops (more to come on this in the future; check back in early 2017 for an update), we anticipate that coverage will be expanded to include the initial prostate biopsy.

At Regional Urology, we continue to strive to offer our patients the very best care available. By now offering MRI-fusion prostate biopsy we continue to do so.

Chris Cefalu, M.D.

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