Our Summary

This study aimed to understand the effectiveness of using MRI and ultrasound-guided biopsies to detect prostate cancer in patients who have and have not had previous biopsies.

The study included 219 men who had both types of biopsies between 2014 and 2018. Those who showed signs of prostate cancer in an MRI had an additional type of biopsy using a fusion of MRI and ultrasound imaging.

The results showed that overall, 63.5% of cancers were detected. The detection rate varied depending on the patients’ Prostate Imaging Reporting and Data System (PI-RADS) score, a measure of the likelihood of significant prostate cancer. Specifically, those with the highest PI-RADS score had an 86.2% detection rate.

When looking at only one type of biopsy, the detection rates were slightly lower (55.7% for targeted biopsy and 57.5% for systematic biopsy). Also, the detection rate was higher in patients who had never had a biopsy before, compared to those who had one negative biopsy in the past.

In conclusion, using MRI can improve the chances of detecting prostate cancer, especially in patients with higher PI-RADS scores and in those who have not had a previous biopsy. Combining both targeted and systematic biopsy methods further improves the accuracy of diagnosis.

FAQs

  1. What was the main goal of this study on prostate biopsies?
  2. How does the use of MRI and ultrasound-guided biopsies improve prostate cancer detection?
  3. How does a patient’s PI-RADS score affect the detection rate of prostate cancer?

Doctor’s Tip

One helpful tip a doctor might give a patient about prostate biopsy is to discuss the option of using MRI-guided biopsy in addition to the traditional ultrasound-guided biopsy. This combination can improve the accuracy of detecting prostate cancer, especially in patients with higher risk factors. It is also important for patients to understand their PI-RADS score and how it can affect the detection rate of cancer. Additionally, patients who have never had a biopsy before may have a higher detection rate compared to those who have had a negative biopsy in the past. It is important for patients to have a discussion with their doctor about the best approach for their individual situation.

Suitable For

Patients who are typically recommended for a prostate biopsy include those with elevated levels of prostate-specific antigen (PSA) in their blood, abnormal digital rectal examination findings, or suspicious findings on imaging tests such as MRI. Additionally, patients who have a family history of prostate cancer or other risk factors may also be recommended for a biopsy. This study suggests that using MRI and ultrasound-guided biopsies can be particularly effective in detecting prostate cancer in patients with higher PI-RADS scores and those who have not had a previous biopsy.

Timeline

Before prostate biopsy:

  1. Patient may experience symptoms such as frequent urination, blood in urine, or difficulty urinating.
  2. Patient may undergo a physical examination and blood tests to check prostate-specific antigen (PSA) levels.
  3. Patient may undergo a prostate MRI to assess the size and shape of the prostate gland and detect any abnormalities.

After prostate biopsy:

  1. Patient may experience some discomfort or pain in the prostate area and may notice blood in the urine or semen.
  2. Patient will receive the biopsy results, which may indicate the presence or absence of prostate cancer.
  3. Depending on the results, patient may undergo further tests or treatments, such as additional biopsies, surgery, or radiation therapy.
  4. Patient will continue to be monitored regularly for any changes in prostate health.

What to Ask Your Doctor

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

  1. What are the benefits of using MRI and ultrasound-guided biopsies compared to traditional biopsies?
  2. How accurate are MRI and ultrasound-guided biopsies in detecting prostate cancer?
  3. What is my PI-RADS score and how does it affect the likelihood of detecting significant prostate cancer?
  4. What is the difference between targeted and systematic biopsy methods, and why is it important to use both?
  5. How does having a previous negative biopsy affect the accuracy of detecting prostate cancer?
  6. Are there any potential risks or side effects associated with MRI and ultrasound-guided biopsies?
  7. How long does it take to get the results of a prostate biopsy?
  8. What are the next steps if prostate cancer is detected during the biopsy?
  9. Are there any alternative screening methods or treatments available for prostate cancer?
  10. How often should I undergo prostate biopsies for monitoring or follow-up purposes?

Reference

Authors: Preisser F, Theissen L, Wenzel M, Humke C, Bodelle B, Köllermann J, Kluth L, Banek S, Becker A, Roos F, Chun FK, Mandel P. Journal: Eur Urol Focus. 2021 Jan;7(1):39-46. doi: 10.1016/j.euf.2019.06.015. Epub 2019 Jul 8. PMID: 31296485