PROSTATE CANCER DIAGNOSIS AND INTERVENTION
Informed Decisions to Help Plan Your Treatment
Desert Medical Imaging has been a leader in medical imaging services since 1998 and will continue to lead the charge in early detection of prostate cancer as Halo Diagnostics' global center for innovation.
Prostate cancer detection, diagnosis and treatment is an ever evolving field. Gone are the days of solely relying on PSA tests, Digital Rectal Exams (DRE) and blind TRUS biopsies with biopsy cores taken randomly without seeing the tumor.
When a man is suspected of having prostate cancer, as a result of a rise in PSA, positive DRE or urinary symptoms, a multi-parametric MRI (mpMRI) scan of the prostate can be used to identify suspicious areas.
If a suspicious area is found, we can perform a targeted MRI-guided biopsy. This approach provides greater accuracy in diagnosis with fewer needle cores being taken, resulting in less pain and a lower risk of infection. An mpMRI scan and MRI guided biopsy are invaluable tools for treatment planning, no matter which course of treatment you choose.
Click here to find if mpMRI is a good option for your diagnosis! Call us at (833) GO4-HALO or (833) 464-4256.
LASER FOCAL THERAPY (LITT OR FLA)
In 2010 the team of Bernadette Greenwood, BSc, PG Cert., RT(R)(MR) and Roger J. McNichols, PhD developed a unique approach using the Visualase® Thermal Therapy System (Medtronic) and the Invivo DynaCAD and Invivo DynaTRIM prostate biopsy system from Philips to perform Laser Interstitial Thermal Therapy (LITT) or Focal Laser Ablation (FLA) and began conducting an IRB-approved Clinical Trial, NCT 02243033. The first case in the world was performed by Dr. John Feller, Dr. McNichols and Ms. Greenwood in May, 2010 as part of a Phase I Clinical Trial.
The procedure involves placing the patient inside the MRI scanner and displaying MRI images and thermal maps on a computer screen. A thin laser fiber is guided to the tumor and laser energy is applied to heat, coagulate and kill the cancer cells. The temperature and the extent of the ablation zone are constantly monitored with MR imaging. The result is the elimination of MRI-visible cancer with very low risk of side effects.
If it is determined through an mpMRI scan and MRI guided biopsy that you might be a good candidate for the procedure, this might be a treatment option for you to consider.
The Prostate Program at Desert Medical Imaging has further expanded to include tissue-based genomics, PET/CT Clinical Trials and blood tests for circulating tumor cells (CTCs).
FOR MORE INFORMATION
We are always here for you! Contact us to schedule an appointment or to talk to one of our clinicians.
MEET OUR SPECIALISTS
Our Team of Qualified Health Care Providers
mpMRI Policy Update
AUA updates policy statement on mpMRI for prostate cancer
This update to the original statement, published in October 2017, is now endorsed by both the American Urological Association (AUA) and the Society of Abdominal Radiology.
In essence, research supports use of a quality prostate MRI before an initial biopsy in men at risk of harboring prostate cancer and in men with a rising PSA after an initial negative standard prostate biopsy, according to the expert panel.
(Source: Dr. Bjurlin, of Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill).
Imaging-guided Precision in Diagnosis
Image-guided biopsy focused on tumor suspicious region. Minimally invasive and elemental for treatment decisions.
Real-time monitoring provides precision in prostate biopsy.
This is a highly specific image-targeted biopsy technique, mpMRI aids in 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 blind approach in transrectal ultrasound-guided biopsy (TRUS), where biopsy cores are taken randomly without seeing the tumor within the prostate gland.
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FREQUENTLY ASKED QUESTIONS
HOW DO I DECIDE IF MPMRI IS A GOOD OPTION FOR ME?
mpMRI may be a good option for you if you have
A. Clinical suspicion of prostate cancer
Prostate-specific antigen (PSA) levels in the blood >4 ng/ml, abnormal digital rectal exam, and no prior history of prostate biopsy
Active surveillance in patients with Gleason score 6 or grade group 1 and PSA <10 ng/ml
B. Managing prostate cancer in patients post-treatment
Monitoring patients with biochemical recurrence of prostate cancer following treatment (prostatectomy or radiation)
WHAT ARE THE ADVANTAGES OF IMAGING-GUIDED BIOPSY OVER CONVENTIONAL TRUS BIOPSY?
Imaging-guided biopsy has the following advantages
The MRI-guided biopsy is 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 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
WHAT SHOULD I EXPECT BEFORE THE (MR-GUIDED) BIOPSY PROCEDURE?
Most patients visiting the clinic are concerned about the actual procedure and what it entails.
At DMI we believe in providing care with advanced technology.
Patients can request a consultation with one of our expert clinicians to address questions and uncertainties around the procedure.
Prior to the procedure, they are also provided an informed consent form that details the risks and benefits.
Patients are recommended to discontinue anticoagulants at least five days before the biopsy.
Antibiotics are administered during the biopsy to avoid any infection or inflammation. We use numbing jelly to make sure the patients have an overall comfortable experience.
WHAT IS GLEASON SCORE?
Gleason score is an indicator of prostate cancer condition - higher scores mean more aggressive cellular architecture (think of golf scores!).
It is the sum of two numbers, Primary Gleason Grade and Secondary Gleason Grade, ranging from 1-5 that indicate the pathology of the cells in the tumor. A lower number indicates that the biopsy is closer to normal tissue and vice versa.
The Gleason Scores (sum of Grades) range between 6-10 and describe the aggressiveness of the disease. Higher scores (8 and above) predict that cancers might grow and/or spread quickly. A Gleason score 7 (4+3/ 3+4) suggests intermediate risk with 4+3 being at a higher risk of progression than 3+4 (as the 4 pattern is dominant).
Hear From Our Patients!
When my first Urologist suggested I use his procedure to remove my prostate, I decided to look for other alternatives. In my search, I came across this ablation procedure and thought that it would work best for me. I contacted DMI and set up and appointment and after initial testing and imaging, decided to go with it. I’m so glad I did. It’s been 10 months since my procedure and PSA is down to 1.4 now, and the images show a clean and healthy prostate gland. Everyone on the staff and those who worked directly with have been an absolute joy to work with.
M.E.F., Scottsdale, AZ
Since April 1 when Dr. May located the small tumor in the left anterior lobe, a second tumor had started in the right anterior lobe. Because of early detection by the MRI biopsy, the cancer was contained and removed before it had a chance to spread. Several of my physician friends have confirmed that it was very rare to detect such an aggressive cancer in the anterior lobe this early and the routine ultrasound biopsy would not have caught it. Months of waitful watching could have been deadly.
B.K., Springfield, Illinois