Can Imaging Rule Out The Need For Biopsy?

By: Dan Sperling, MD

It’s exciting to be involved in medicine at this point in history when it seems like practically every week some new breakthrough makes life better and longer for patients. Think about it: a discipline like surgery has been around since ancient times, but it took thousands of years to overcome the problems of pain, bleeding and infection. It wasn’t until the 19th century that anesthesia, new ways to tie off or cauterize blood vessels, and antiseptics were all developed. I have to ask myself, how long will it be before needle biopsies to diagnose cancer in the lung, breast, prostate, etc. will be replaced by diagnostic imaging?  

Well, if you’re one of the countless patients who wish the time has come, you’re not alone—and I join you in that wish. However, imaging can at least help indicate whether a biopsy is immediately necessary or not—or maybe not at all.

I discovered an interesting study out of the Urologic Oncology Branch of the National Cancer Institute (Bethesda, MD). The study, “Low suspicion lesions on multiparametric magnetic resonance imaging predict for the absence of high-risk prostate cancer,” is a response to the acknowledged problem of overtreating some patients whose prostate cancer might never become life-threatening. 

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