MRI Fusion Prostate Needle Biopsy- What's The Big Deal??

Prostate needle biopsy is far from infallible, but remains the best and only tool for diagnosing prostate cancer and determining prostate cancer grade.

 

We see many men with elevated PSA whom have had a previous prostate needle biopsy showing now evidence of cancer.  

So why then is the PSA elevated?  And are we sure there is no prostate cancer?

In the past, a continued rise in PSA or concerning digital rectal exam would trigger yet another (and possibly another) prostate needle biopsy.

The reassuring news is that prostate parametric MRI adds a new dimension for assessing the prostate.  

A prostate MRI does not require a rectal probe, yet even more good news.

If the MRI shows concerning findings, this may trigger a repeat MRI fusion biopsy.

The radiologist reads the MRI and scores it on a scale of 1-5.  This is called a "PIRADS" scale, and 5 is the most concerning, 1 the least.  Anything 3 or greater can be a cause for concern.

In this event, we may, with the help of Inland Imaging, contour the MRI and then overlay this image with the transrectal ultrasound that is being done live in our office.  This is true MRI fusion needle biopsy. Until we brought this to our practice in 2017, this was not previously available in the Inland Northwest, and at only a handful of practices in Seattle and Portland.

This tool has credible data behind it to help diagnose or exclude prostate cancer, and is a valuable asset for our patients that are on active surveillance for management of their low risk prostate cancer.  

Want to know more about MRI fusion biopsy and the data behind it?  

https://www.auanet.org/guidelines/prostate-mri-and-mri-targeted-biopsy

Author
Levi Deters, MD

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