Numerous studies have shown that multiparametric MRI (mpMRI) of the prostate before biopsy improves the detection rate and diagnosis accuracy of targeted biopsies. A summary of the importance of targeted vs. systematic TRUS biopsies bears repeating. If you or someone you love is being recommended for a prostate biopsy, here are key points about traditional 12-core TRUS biopsies to keep in mind:
- TRUS biopsies are basically blind and random, so they often completely miss prostate cancer. When this happens, a “negative” result cannot be trusted.
- TRUS biopsies often under-sample a tumor by hitting at the edge instead of striking the core where the most aggressive cancer cells are more likely to be.
- TRUS biopsies may pick up insignificant prostate cancer (very small Gleason 3+3 tumors) that may be amenable to active surveillance, yet countless patients have undergone radical surgery, perhaps needlessly, and suffer from incontinence and/or sexual dysfunction as a result.
- TRUS biopsies of 12 or more needles have an increased risk of infection from bowel bacteria in the prostate or surrounding tissue due to the numerous times the wall of the rectum is punctured.
Now compare the above points with the important advantages of obtaining a pre-biopsy multiparametric MRI and using the results to guide a targeted biopsy if imaging shows a suspicious area:
- mpMRI shows four functional differences between healthy prostate tissue and diseased prostate tissue, including prostate cancer.
- mpMRI is especially sensitive to significant prostate cancer, which is the kind that should be biopsied and treated. More men may be able to hold off on a biopsy and monitor by imaging if the MRI does not show significant prostate cancer.
- mpMRI reveals the location of any prostate cancer, greatly reducing the number of sampling needles. This also greatly reduces the risk of infection.
- mpMRI guides a sampling needle into the center of a suspicious area, where the most dangerous cell lines are likely to be found. Thus, the biopsy results are more trustworthy, and treatment can be planned accordingly.
At our Center, we offer state of the art multiparametric MRI using a 3 Tesla (3T) magnet, which improves the quality of images over those obtained on a 1.5T magnet. We do not use an endorectal coil, thanks to the strength of our magnet. In addition, our protocol includes the full range of imaging parameters which, when taken together, provide an extraordinarily accurate picture of each patient’s prostate gland and any abnormality it may contain. For more information, visit our page on MRI Guided Biopsy at https://sperlingprostatecenter.com/mri-guided-biopsy-new-york-city/.