MRI-guided prostate biopsy enables more precise cancer care

Oncologists at the University of California San Diego Moores Cancer Center are using MRI with traditional ultrasound prostate exams to produce three-dimensional images of the prostate that enable physicians to see previously undetectable growths.

"With an ultrasound exam, we are typically unable to see the most suspicious areas of the prostate, so we end up sampling different parts of the prostate that statistically speaking are more likely to have cancer," J. Kellogg Parsons, a urologic oncologist who is helping to pioneer the new technology, said in an announcement. "The MRI is a game-changer. It allows us to target the biopsy needles exactly where we think the cancer is located. It's more precise."

The technique calls for the patient to undergo an MRI before a biopsy exam. Working with David Karow, a UCSD Heath System radiologist, Parsons combines the MRI images with real-time, ultrasound sound biopsy images to produce what he a calls a "road map" of the prostate.

"The MRI-guided prostate biopsy will enhance the patient experience by reducing the number of false-positive biopsies and resulting in earlier diagnosis when cancer is present," Parsons said.

Research published in the Journal of Urology in December 2012 confirmed the effectiveness of imaging-guided targeted biopsy of the prostate. In that study, researchers at the University of California Los Angeles, evaluated prostate cancer detection rates in 171 men using MRI-ultrasound fusion biopsy. They found that targeted biopsy was three times more likely to identify cancer than a traditional systematic biopsy.

"Targeted prostate biopsy has the potential to improve the diagnosis of prostate cancer and may aid in the selection of patients for active surveillance and focal therapy," the researchers concluded.

Additionally, a study published earlier this year by Australian researchers and presented at the European Association of Urology Annual Congress also came down on the side of targeted MRI-guided biopsy.  

"MRI has now become the investigation of choice for all men with suspected prostate cancer; it has completely radicalized and changed our paradigm," study coauthor Morgan Pokorny, a urologist from the Wesley Hospital in Brisbane, Australia, told Medscape Medical News.

To learn more:
- see the announcement from the University of California San Diego
- see the Medscape Medical News article