Targeted Imaging-guided Diagnosis and Personalized Care
Real-time monitoring provides precision in prostate biopsy
This is a highly specific biopsy technique guided by multiparametric MRI (mpMRI). Real-time detection of the tumor suspicious region prior to the biopsy and then a needle is used to sample only the suspicious area within the gland, sparing healthy tissue.
Unlike the conventional 12-core transrectal ultrasound-guided biopsy (TRUS) approach, where biopsy cores are taken randomly without seeing the tumor within the prostate gland.
ADVANTAGES OF IMAGING-GUIDED BIOPSY
How is imaging-guided biopsy better than ultrasound-guided biopsy?
- Specific targeting of tumor suspicious region instead of random sampling (TRUS biopsy can miss aggressive cancer lesions about 30-35% of the time)
- Minimally invasive with fewer cores (3-4) instead of 12 core TRUS Bx
- Reduced pain and damage to the rectal wall
- Reduced chances of infection
Increased sensitivity of detecting aggressive lesions with decreased potential for detecting indolent disease. This reduces overtreatment and prevents the psychological burden with misclassification of cancer stage
- Precision in diagnosis
- Better spatial localization with specialized software to reach tumor suspicious regions otherwise difficult to reach with TRUS
TRUS biopsy can underscore lesions due to its inherent random nature. An aggressive cancer could be “skimmed” or completely missed. A low grade tumor might be sampled while an aggressive one is completely missed.
Study shows MRI-guided biopsy is more accurate than TRUS biopsy in detecting clinically significant prostate cancer
Conclusions from clinical study to compare the accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer suggest:
- Nearly 27% fewer patients with elevated PSA levels had to get a prostate biopsy
- 5% fewer clinically insignificant cancers were detected
- 18% more cases of clinically significant cancer were identified
(Ref: Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, Kirkham AP, Oldroyd R, Parker C, Emberton M. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017 Feb 25;389(10071):815-822. doi: 10.1016/S0140-6736(16)32401-1. Epub 2017 Jan 20. PubMed PMID: 28110982.