MRI-TARGETED BIOPSY WAS SUPERIOR TO STANDARD TRANSRECTAL ULTRASONOGRAPHY-GUIDED BIOPSY IN MEN AT CLINICAL RISK FOR PROSTATE CANCER WHO HAD NOT UNDERGONE BIOPSY PREVIOUSLY.
(Conclusions from the PRECISION trial, NTC02380027)
Diagnosing Prostate Cancer With Precision
HALO’s MRI-Guided Biopsy
At HALO Diagnostics, we use MRI-guided biopsy to verify if or what type of cancer is present. MRI-guided biopsy is performed under an MRI which allows the team to guide a biopsy needle in real-time and target exactly the area of the prostate that looked suspicious under the screening mpMRI. This approach can ensure a more accurate sampling without damaging healthy prostate tissue compared to more traditional approaches.
More traditional prostate biopsy procedures, like a transrectal ultrasound (TRUS) guided biopsy, take a “poke and hope” approach – poke the prostate multiple times and hope to hit the right area of the gland. With a TRUS biopsy, cores are taken with much less clear views of the prostate which often can lead to missing tumors at the front of the gland (area most distant from the rectal wall) and under-sampling the area furthest from the bladder. Because of this, a TRUS biopsy can miss 30% or more of cancers, potentially leading to inaccurate diagnoses.
Another frequently performed prostate biopsy is an MRI/Ultrasound Fusion Guided Biopsy. This approach can be more accurate than the traditional TRUS biopsy. To perform a fusion biopsy, a urologist will combine previously obtained MRI images of the prostate with real-time ultrasound imaging (hence the term fusion). While often not as accurate as an MRI-guided biopsy, MRI/Ultrasound Fusion Guided Biopsy is an improvement over the traditional TRUS approach.
(Conclusions from the PRECISION trial, NTC02380027)
WATCH: HALO Dx Chief Medical Officer, Dr. John F. Feller explains why an MRI-guided biopsy provides patients with a more accurate diagnosis with less pain and fewer side effects.
Much like the prostate specific antigen that is used in PSA testing, there are other biomarkers that may help your physician diagnose prostate cancer. HALO Dx works with ExosomeDx™ and is proud to offer the ExoMDx Prostate Test, a urine-based test that is used similarly to a PSA test before biopsy. The test analyzes three cancer-specific biomarkers found in the urine that are associated with aggressive prostate cancer. These biomarkers or genes in this case are: ERG, PCA and SPDEF. This simple non-invasive test can help assess your risk of having clinically significant high-grade prostate cancer and help you and your doctor determine whether to proceed with or defer a prostate biopsy.
Along with traditional pathology of the biopsy results, HALO Dx offers genomic tests on the same tissue sample to help identify the appropriate treatment option(s) and help determine the metastatic potential of the tumor through the Decipher® Prostate Cancer Test. We have seen impressive results over the years and have demonstrated that the Decipher test can be used to help predict response to Laser Focal Therapy.
Also called low grade
The cancer is likely to grow and spread very slowly.
If the cancer is small, many years may pass before it becomes a problem. Thus, you may never need cancer treatment.
Also called intermediate grade
The cancer is likely to grow and spread slowly at a modest pace.
If the cancer is small, several years may pass before it becomes a problem. To prevent problems, treatment may be needed.
Also called high grade
The cancer is likely to grow and spread fast.
If the cancer is small, few years may pass before it becomes a problem. To prevent problems, treatment may be needed.
Gleason scores are organized into grade groups. Grade groups are meant to be simpler and more accurate by breaking up Gleason score 7 into two subgroups. This helps prevent over treatment for those with low-grade prostate cancer. Grade Group 2 (Gleason pattern 3+4) means that the cancer cells in the largest area of the cancer are less aggressive than the cancer cells in the second largest area, and Grade Group 3 (Gleason pattern 4+3) means that the cancer cells in the largest area of the cancer are more aggressive than the cancer cells in the second largest area.
| Grade Group | Gleason Score | Gleason Pattern |
|---|---|---|
| 1 | Gleason score 6 or less | Gleason pattern 1+3, 2+3, 3+3 |
| 2 | Gleason score 7 | Gleason pattern 3+4 |
| 3 | Gleason score 7 | Gleason pattern 4+3 |
| 4 | Gleason score 8 | Gleason pattern 4+4, 3+5, 5+3 |
| 5 | Gleason score 9 or 10 | Gleason pattern 4+5, 5+4, 5+5 |
A Combat Medic and Radiographer in the U.S. Army, she attended University of Maryland, Asian Division while stationed in Seoul, South Korea and earned a BSc in Radiologic Sciences from Adventist University. She earned her Postgraduate Certificate in Imaging at the University of Edinburgh. Bernadette has worked in government, industry, clinical and research settings. With 30 years’ experience in medical imaging, marketing, clinical education, regulatory affairs, product management and R&D, she conceptualized and developed focal laser interstitial thermal therapy of prostate cancer with a trans-rectal approach under MRI guidance in 2009 (patent pending). Preclinical testing was conducted at MD Anderson Cancer Center and the first transrectal laser procedure on a human research subject was performed at Desert Medical Imaging in May, 2010.
Explore the Prostate Program
Minimally invasive focal laser ablation for prostate cancer, invented by Bernadette M. Greenwood, RT(R)(MR)(ARRT), PhD(c) and refined at HALO.
Precision treatment options for benign prostatic hyperplasia (enlarged prostate).
*International experts agree that most focal therapy techniques remain investigational and should be performed under IRB-approved protocol and/or contribute to an IRB-approved registry – the HALO way.