Combining two imaging techniques to create a 3-D image of the prostate may greatly improve a specialist’s ability to view and judge suspicious areas, and determine whether and where prostate cancer may be evident, according to a study published in Urologic Oncology.
The study, “Magnetic resonance/transrectal ultrasound fusion biopsy of the prostate compared to systematic 12-core biopsy for the diagnosis and characterization of prostate cancer: multi-institutional retrospective analysis of 389 patients,” combines magnetic resonance imaging (MRI) images with transrectal ultrasound (TRUS), creating a fusion biopsy technique called MRI-TRUS that helps to more accurately identify potential anomalies in the prostate and choose which specific part of the tissue should be analyzed for the presence of cancer.
Prostate cancer is generally suspected by analyzing of PSA levels in biopsies. The MRI-TRUS procedure has been shown to find more cancer cases, and to distinguish between dangerous and less aggressive tumors.
The MRI-TRUS technique requires special imaging equipment and the collaborative work of radiologists and urologists, who receive high-level training before using the equipment. In this procedure, patients at risk of prostate cancer undergo an MRI examination to look for potential anomalies and, if any are detected, MRI images are sent to a device that combines them with ultrasound images. The final 3-D image helps physicians choose if a biopsy is necessary and the location biopsy tissue should be taken from for further analysis.
This fusion biopsy technique has been used in nearly 1,000 patients over almost three years by researchers at the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern, in Texas, and, they reported, has provided evidence of its superior capacity in diagnosing the disease.
In this follow-up study involving 389 men, developed in partnership with Brazilian colleagues, researchers showed the procedure consistently and reliably detected prostate cancer, even when using different equipment and protocols.
Specifically, the researchers reported that “Compared with systematic biopsy, targeted biopsy diagnosed 11% (37 vs. 26) more intermediate-to-high risk … and 16% (10 vs. 16) fewer low-risk tumors … These results were replicated when data from each center, biopsy-naïve patients, and men with previous negative biopsies were analyzed separately.”
“In many instances, MRI-TRUS biopsies performed at UT Southwestern have allowed us to diagnose and treat aggressive prostate cancer in patients whose prior biopsies failed to find the cancer,” Ivan Pedrosa, MD, with the Advanced Imaging Research Center at UT Southwestern, said in a news release. “Because of its improved precision, patients and physicians are better informed to choose the most appropriate treatment. This helps to avoid surgery in patients with less aggressive disease, and ensures that patients with more aggressive cancers are identified earlier.”