Category: Biopsy
The Five Problems with TRUS Biopsy
Up till now, prostate cancer has been the only tumor cancer diagnosed by random luck. That’s right, random luck. The most common type of prostate biopsy is guided by transrectal ultrasound, or TRUS. It is considered the “gold standard” for prostate biopsy because it’s most widely used by urologists... keep reading
MRI Is Changing Prostate Biopsy
A couple of years ago I saw a patient who previously had three negative TRUS-guided prostate biopsies. Because his PSA had been slowly rising from 4 to 10, the number of biopsy needles had increased from 10 to 12 to 14... keep reading
The Truth About Biopsy “Track Seeding”
More than six years ago, we published a blog post in hopes of reducing patient fears that a needle biopsy of the prostate could spread prostate cancer. Back then, we referred to occurrence of track seeding in prostate biopsies as exceedingly rare. This is what the latest research tells us today... keep reading
ED After TRUS Biopsy of the Prostate
Early in 2021, two separate literature reviews were conducted, and both had similar findings. The first included 7 full text articles from which data was assembled and analyzed. Based on standardized erectile function self-report questionnaires, the authors found that... keep reading
Is it Necessary to Add 12-Core TRUS Biopsy on top of Fusion-Targeted Biopsy?
A guidance system is a virtual or physical device, or a group of devices implementing a controlling the movement of a ship, aircraft, missile, rocket, satellite, or any other moving object. (Wikipedia) When you read the above quote, what comes to mind? For some, “guidance system” suggests their GPS navigation system to get them where keep reading
How Important is an Expert?
The title question is a decoy. Here’s the real issue: How important is your body? The more you value your body’s health, the more it’s worth seeing the best expert available if something goes wrong. It’s like anything you love, appreciate and value. When all is well, we tend to take for granted that matters keep reading
Why Fusion-Guided Biopsies Should Not Be Called “MRI-Guided Biopsies”
Fusion guided prostate biopsies are the new darling of urologic diagnostic procedures. For decades, the transrectal ultrasound (TRUS) guided 12-plus needle sampling of the gland was the prostate cancer (PCa) diagnostic gold standard, despite its widely recognized shortcoming: Inaccuracy rates of at least 30% on average Overdetecting insignificant PCa while often missing significant PCa Tends keep reading
A Critique of Transperineal Biopsy Study On MRI/Ultrasound Fusion Guidance
I read a study on the accuracy of prostate MRI for predicting that no prostate cancer (PCa) is present. This is called the negative predictive value (NPV), and the authors make a great point in their introduction: The reliability of a negative MRI is a key clinical metric – if the MRI is reported as keep readingTRUS Biopsy: Still Trying to Solve the Riddle
Matt Mullenweg, the originator of the popular open source WordPress software, has been quoted as saying, “Whenever there’s a new form of media, we always think it’s going to replace the old thing, and it never does. We still have radio, however long after TV was introduced.” It can be just as true in medicine. keep reading