A Urology Team Center of Excellence

MRI Guided Biopsy

For several decades, Urologists have traditionally performed Transrectal Ultrasound guided biopsies to help locate and diagnose prostate cancer. With the guidance of ultrasound imaging, the prostate is divided into 12 quadrants, wherein a needle biopsy is taken from each of these quadrants in an attempt to locate suspicious areas that may be cancerous. While 12 biopsies are standard, many more may be taken based on the poor resolution of ultrasound imaging. Unfortunately, after taking many biopsies using the Transrectal Ultrasound process, cancer cells can still be missed and left to spread.

The latest generation of prostate cancer detection is through the use of MRI Guided Biopsies, a more precise tool for locating, diagnosing and ultimately treating prostate cancer. The Urology Team is one of the first in the United States to utilize the UroNav Fusion Biopsy System for MRI Guided Biopsies.

With this new technology, patients who have an elevated PSA, a high Gleason score and/or questionable rectal exam results, will be identified as needing further evaluation. These patients will start by having a multiparametric MRI image taken of their prostate gland in order to detect suspicious lesions within (or outside) the capsule. This MRI image will then be “fused” with an ultrasound image to help pinpoint indeterminate areas of the prostate for needle biopsy. When reviewing the MRI image, a Radiologist will mark “targets” on the image that identify areas to be specifically focused on when performing the needle biopsies.

During the biopsy process, a special ultrasound will be inserted into the patient’s rectum. This ultrasound is equipped with a GPS tracking system that assists the Urologist in locating the “targets” identified by the Radiologist on the MRI image – displayed on a large screen in front of the doctor. Once the biopsy ultrasound has been positioned at the location of a target, a needle is deployed from the ultrasound to take a biopsy from the exact location indicated by the MRI fused image. Essentially, guess work is taken out of the biopsy process and is replaced with precision targeting.

MRI Guided Biopsy Advantages

  • Eliminates multiple random (blind) biopsies
  • May detect aggressive tumors that may have otherwise been missed
  • Precisely targets suspicious area of interest in the prostate
  • Ability to more accurately identify and test areas for more precise diagnosis
  • More accurate diagnosis helps avoid too much treatment, not enough treatment, or unnecessary treatment
  • Fuses and displays MRI and ultrasound images to visualize suspicious areas of the prostate while assisting physicians with a projected biopsy needle path
  • Beneficial for patients who have had numerous biopsies with ambiguous results
  • MRI fused imaging may negate the need for a prostate biopsy based on findings

 

Two pivotal events have changed the diagnosis of Prostate Cancer. First, a Multiparametric MRI shows the Urologist areas of suspicion in the prostate that may harbor cancer. Second is the MRI fusion guided biopsy apparatus – the UroNav Fusion Biopsy System – which allows us to overlay the prostate ultrasound directly on the MRI image, thereby enabling direct fusion guided biopsies to suspicious areas.” – Dr. Richard Chopp