Our Summary

This research paper discusses the limitations of traditional ultrasound-guided prostate biopsies, including the fact they can often miss significant cases of prostate cancer or over-diagnose non-threatening cases. The paper suggests that multiparametric MR imaging of the prostate can provide a better location of prostate tumors compared to ultrasound imaging. This method could help overcome these limitations. The identified lesions can be targeted for biopsy either directly in the machine (in-gantry) or indirectly using a fusion of MR imaging and ultrasound imaging. This fusion can be done visually by the operator or through a software fusion device. The paper reviews different techniques for MR imaging-targeted prostate biopsies and discusses their potential impact on diagnosing prostate cancer.

FAQs

  1. What are the limitations of traditional ultrasound-guided prostate biopsies?
  2. How does multiparametric MR imaging of the prostate improve the location of prostate tumors compared to ultrasound imaging?
  3. What are the different techniques for MR imaging-targeted prostate biopsies discussed in the research paper?

Doctor’s Tip

A doctor might advise a patient undergoing a prostate biopsy to consider requesting a multiparametric MR imaging of the prostate in addition to the traditional ultrasound-guided biopsy. This can help improve the accuracy of locating and diagnosing prostate tumors, potentially reducing the risk of missing significant cases of prostate cancer or over-diagnosing non-threatening cases. By targeting specific lesions identified through MR imaging, the biopsy procedure can be more precise and potentially more effective in detecting and diagnosing prostate cancer.

Suitable For

Patients who are typically recommended for prostate biopsy include:

  1. Patients with elevated PSA levels: Prostate-specific antigen (PSA) levels can be indicative of prostate cancer, and patients with elevated levels may be recommended for a biopsy to confirm or rule out the presence of cancer.

  2. Patients with abnormal digital rectal exam (DRE) findings: Abnormalities in the prostate detected during a digital rectal exam may also warrant a prostate biopsy to further investigate potential cancerous lesions.

  3. Patients with a family history of prostate cancer: Individuals with a family history of prostate cancer are at an increased risk of developing the disease themselves, and may be recommended for a biopsy as a precautionary measure.

  4. Patients with suspicious imaging findings: Multiparametric MR imaging of the prostate can identify suspicious lesions that may indicate the presence of prostate cancer. Patients with such findings may be recommended for a biopsy to confirm the diagnosis.

  5. Patients with prior negative biopsies but ongoing concerns: In cases where previous biopsies have been negative but there are ongoing concerns about the possibility of prostate cancer, a repeat biopsy may be recommended to further investigate the issue.

Overall, patients who are recommended for prostate biopsy are those who are at a higher risk of developing prostate cancer or have findings that warrant further investigation to accurately diagnose and treat the disease.

Timeline

  • Patient is referred for a prostate biopsy after abnormalities are found during a routine screening test, such as a PSA test.
  • Patient undergoes a consultation with a urologist to discuss the risks and benefits of a prostate biopsy.
  • Patient may be instructed to stop taking certain medications, such as blood thinners, before the biopsy.
  • On the day of the biopsy, patient is given antibiotics to reduce the risk of infection.
  • During the biopsy, a thin needle is inserted into the prostate gland to collect tissue samples for analysis.
  • After the biopsy, patient may experience some discomfort, blood in the urine or semen, and difficulty urinating for a few days.
  • Patient receives the results of the biopsy, which may indicate the presence or absence of prostate cancer.
  • If cancer is detected, patient may undergo further tests and treatments, such as surgery, radiation therapy, or active surveillance.
  • If no cancer is detected, patient may continue with regular monitoring and screening for prostate cancer.

What to Ask Your Doctor

Some questions a patient should ask their doctor about prostate biopsy include:

  1. What are the potential risks and complications associated with a prostate biopsy?
  2. How accurate is a traditional ultrasound-guided prostate biopsy in detecting prostate cancer compared to MR imaging-targeted biopsies?
  3. What are the benefits of undergoing a multiparametric MR imaging-targeted prostate biopsy?
  4. Will I need anesthesia for the biopsy procedure?
  5. How long will it take to receive the biopsy results?
  6. What are the next steps if the biopsy results come back positive for prostate cancer?
  7. Are there any alternative options to a prostate biopsy that I should consider?
  8. How experienced is the healthcare provider in performing MR imaging-targeted prostate biopsies?
  9. Will I need to undergo additional tests or procedures after the biopsy?
  10. What is the likelihood of needing a repeat biopsy in the future?

Reference

Authors: Sarkar S, Verma S. Journal: Radiol Clin North Am. 2018 Mar;56(2):289-300. doi: 10.1016/j.rcl.2017.10.010. Epub 2017 Nov 26. PMID: 29420983